Household Survey Questionnaire Editable Sample 1

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Company/Organisation/Institute Name

Housing Questionnaire

Date:

Name of Surveyor: Name of Respondent: Plot no.

Housing detail

1. No. of floors (personal observation)


a. G b. G+1 c. G+2 d.G+3 e. Others, specify (basement, G+5, stilt etc.)________
2. House ownership
a. Owned b. Rented c. Joint ownership b. bought from property dealer
If rented, Monthly Rental Rs._________________
3. If owned, how did u get this plot?
____________________________________________________________________________________
____________________________________________________________________________________
4. Age of structure
a. <5yrs b. 5-10yrs c. 10-30yrs d.>30yrs
5. Plot size ____________
6. Setbacks: Front ______ Rear ________ Side 1 ______ Side2 _________
7. No. of rooms _______________________
8. If Mixed use present, ownership of shop
a. Owned b. Rented c. Joint ownership
9. Servant room present
a. Yes (size...........) b. No
10. Residing since
a. <2 years b. 2-5 years c.5-10 years d. >10 years
11. No. of families residing ____________
12. Any changes done to the original structure? If yes, Specify________________________________

13. Did you did get the plan approved for such changes, if yes how (process & concerned authority)?

14. Do you have parking space inside the plot? A) Yes B) No

15. Place where your servants (drivers, maids, car washers etc) resides?
16. If commercial activity inside plot, what was the procedure to get the approval of carrying out commercial
activity inside plot? Is it Owned or Rented __________________

17. Any problems/complaints faced by you or neighbours with such an activity?

18. Your observations/ opinion about changes in the colony in past 5/10/15 years.

19. Any difficulty faced by you ( parking, physical infra, facilities, water logging areas, light and ventilation , due
to presence of mixed use etc.)

20. Any improvement you would like to see in the area.

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