Woods Cross Subsidence Name Question Title * 1. Name and Address Name * Address * Email Address Phone Number Question Title * 2. Please identify the issues you have had, when you noticed them, and if they're getting worse. (If you have previously filled out a questionnaire and sent it into the city answer this question only if you need to update any of your previous responses.) First noticed? Getting worse? Location of the issues Basement 2016 2014 to 2015 2013 or earlier Not applicable Basement First noticed? menu Yes No Not sure Not applicable Basement Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Basement Location of the issues menu Cracks in the walls 2016 2014 to 2015 2013 or earlier Not applicable Cracks in the walls First noticed? menu Yes No Not sure Not applicable Cracks in the walls Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Cracks in the walls Location of the issues menu Cracks in the ceilings 2016 2014 to 2015 2013 or earlier Not applicable Cracks in the ceilings First noticed? menu Yes No Not sure Not applicable Cracks in the ceilings Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Cracks in the ceilings Location of the issues menu Cracks in the foundation 2016 2014 to 2015 2013 or earlier Not applicable Cracks in the foundation First noticed? menu Yes No Not sure Not applicable Cracks in the foundation Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Cracks in the foundation Location of the issues menu Cracks in the bricks 2016 2014 to 2015 2013 or earlier Not applicable Cracks in the bricks First noticed? menu Yes No Not sure Not applicable Cracks in the bricks Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Cracks in the bricks Location of the issues menu Porch separating 2016 2014 to 2015 2013 or earlier Not applicable Porch separating First noticed? menu Yes No Not sure Not applicable Porch separating Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Porch separating Location of the issues menu Garage separating 2016 2014 to 2015 2013 or earlier Not applicable Garage separating First noticed? menu Yes No Not sure Not applicable Garage separating Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Garage separating Location of the issues menu Doors not closing 2016 2014 to 2015 2013 or earlier Not applicable Doors not closing First noticed? menu Yes No Not sure Not applicable Doors not closing Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Doors not closing Location of the issues menu Floors settling (sinking) 2016 2014 to 2015 2013 or earlier Not applicable Floors settling (sinking) First noticed? menu Yes No Not sure Not applicable Floors settling (sinking) Getting worse? menu North South East West Southwest Southeast Northwest Northeast Throughout Floors settling (sinking) Location of the issues menu Other (please specify) Question Title * 3. Any other observations that would suggest your home and/or property is settling? Question Title * 4. Please rank the damage done to your home and/or property. Minor Moderate Severe Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 5. Please upload pictures of the issue. DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please upload pictures of the issue. Done