ARULMIGU MEENAKSHI AMMAN COLLEGE OF ENGINEERING
SCHOOL OF ARCHITECTURE (2014-2019)
HOUSE HOLD NO.: _____________________
STREET NAME: _________________________
1. INDIVIDUAL QUESTIONAIRE
• Name:
• Total no. of household members _____________
• No. of Male ________
• Age: 0-8 8-16 16-30 30-50 above 50
• No. of Female ________
• Age: 0-8 8-16 16-30 30-50 above 50
• Address: _________________________________
• Marital status: (A) Married (B) Unmarried
• Is the family members literate or illiterate?
(A) Literate (B) illiterate
• Religion: (A) Hindu (B) Muslim (C) Christian
(D) Buddhist (E) Jain (F)Others_______
• Language: (A) Tamil (B) Malayalam (C) Telugu
(D) Hindi (E) Others_________
• Educational status: (A) below 10th (B) 12thabove
(C) Graduate (D) post graduate
2. INCOME
• Occupation: (A) Public (B) Private (C)Self-emp
(D) domestic work
• Sectors of work: (A) job (B) business (C) Pension
• How long have you been living here as
household/family? ____________ years
• Have you-as a household-ever lived in another
place, such as another town, or abroad, for three
or more months at one time? (A) yes (B) no
DATE: .07.2018
ROAD WIDTH: __________
• Total household income per Annum:
(A) < 50,000 (B) 50k-1l (C) abv 1l
3. HOUSING AND INFRASTRUCTURE
• Type of residence: (A) owned (B) rented
• Building material __________________________
• No. of stories _____________________________
• Vehicles owned by the family: (A) None
(B) bicycles (C) 2wheelers (D) car
• Availability of parking: (A) sufficient (B) non-
sufficient
• Domestic water source for house:
(A) Plumbing inside the house (w/c, kitchen)
(B) Water pump
(C) Well water
(D) Interior water supply system
(E) Metro water source
• Do you have rain water harvesting? yes/no
• Type of fuel used for cooking: (A) LPG/gas (B)
induction (C) others ___________
• Solid wastes disposal:
(A) Metro-poli collects regularly
(B) Disposed to a predefined landfill
(C) Disposed to a wild disposal area
(D) Disposed irregularly / burning
(E) Disposed to the river/lake or others
4. PUBLIC SERVICES
• Whether happy with the public services provided
by the civic authority: yes/no
URBAN DESIGN – TRIPLICANE (1)
 ARULMIGU MEENAKSHI AMMAN COLLEGE OF ENGINEERING
SCHOOL OF ARCHITECTURE (2014-2019)
• Rate the following services/amenities in the city:
{(A)good (B) average (C) poor}
public transport: (A) (B) (C)
sewage management: (A) (B) (C)
solid waste management: (A) (B) (C)
electricity supply: (A) (B) (C)
drinking water supply: (A) (B) (C)
5. EDUCATION
• Do all your children go to school? yes/no
(A) State board/central board (B) pada salai
• Are you satisfied with these education facilities?
Do you have any problem/issues?
6. PUBLIC TRANSPORT
• How often do you use public transport: (A) daily
(B) weekly once (C) less often
• Means of public transport you use: (A) bus
(B)shared auto rickshaw (C)others ____________
• What are commercial options for you: (A) local
markets (B) supermarkets (C) road-side vendors
7. RECREATIONAL FACILITIES
• What are the different recreation facilities,
available? (A) parks (B) cinema theatres (C) drama
or play theatre (D) others ___________________
8. SEWAGE MANAGEMENT
• Is your house/office connected to the city-based
drainage network: yes/no
• If yes, how often is it maintained: (A) weekly once
(B) monthly once (C) less frequent
• Are the drains covered: yes/no
• Do the drains overflow during rains: yes/no
• Do they easily collect water from the roads during
rain: yes/no
9. SOLID WASTE MANAGEMENT
• How far is the garbage bin from your house:
(A) <100m (B) 100m<500m (C) >500m
• Does the garbage bin overflow/spillover: yes/no
• How often the garbage collector vehicle comes to
take the garbage: (A) twice weekly (B) once
weekly (C) less once in 2 week (D) frequent
10. DRINKING WATER SUPPLY
• Do you have public supply for drinking water to
the house: yes/no
• Are there any public drinking facility near your
home/office: yes/no
• If yes specify type: (A) bore well (B) fixed duration
pipe (C) water atm (D) can water
11. ELECTRIC SUPPLY
• Do you have frequent power cuts in electric
provision in your home: yes/no
• Power fluctuation in supply: yes/no
• Any alternative energy resources used: yes/no
• Monthly current consumption: ___________units
12. PUBLIC INFRASTRUCTURE
• Are you satisfied with existing roads: yes/no
• How often are they repaired? (A) every 6 months
(B) every 1 year (C) less frequently
• Quality/standard of railway station (city):
(A) Good (B) fair (C) bad
• Quality/standard of bus stand (city):
(A) Good (B) fair (C) bad
• Problems faced during natural disaster _______
URBAN DESIGN – TRIPLICANE (1)