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Shute Parish Plan Questionnaire – household information

25 July 2010 367 views No Comment

 

HOUSEHOLD INFORMATION

 

1. How many people including children normally live in your household?

Enter number

 

2. Please enter the number of people in your household in each age group.  (Enter numbers)

 

Male Female Male Female

0-4 45-59

5-10 60-64

11-15 65-74

16-17 75-84

18-24 85

25-44

 

3. How long have you lived in Shute Parish? (Tick one box only)

  Person 1 2 3 4 5 6 7 8
Whole life                
Less than 1 year                
1-5 years                
6-15 years                
16-25 years                
26-50 years                
51+ years                

 

4. Where do you live? (Tick one box only)

Shute Whitford Seaton Junction

Umborne Hampton North of the A35

Other ………..…………………………………………………..………………………….

 

5. Are you on Mains water or Private Supply (Circle one)

 

If Mains Water, is it Metered or Unmetered (Circle one)

  1. Are you on

Mains Sewerage / Soakaway / Septic Tank / Own Sewage Plant (Circle one)