This is a questionnaire template.

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Course Code: URP-3210
Course Title: Computer Application in Planning Lab
Questionnaire On
Assessment of municipal services in Pabna
Municipality
Date of Submission: July 01, 2018
Submitted To Submitted By
Md. Kamrul Hasan Group- 04
Lecturer, Dilruba Aktar (151729)
Department of Urban and Regional Planning Ritu Saha (151730)
Atiya Azizah (151732)
Akash Saha (151733)
Laila Arjuman (151734)
Moly Podder (151735)
3rd
Year 2nd
Semester
Session- 2014-2015
Department of Urban and Regional Planning
Pabna University of Science and Technology

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Pabna University of Science and Technology
Department of Urban and Regional Planning
Questionnaire on
Assessment of municipal services in Pabna Municipality
(Academic purpose only)
Today’s date: …………
 Personal information
Name: Sex: Male
Age: Female
Marital status: Married Religion:
Unmarried Educational Background:
Current
Profession:
Monthly income
Address:
Contract number:
 Household Information
Total family members:
No. of children (under 18 years)
No. of aged members (above 50 years)
No. of school going children
Total earning members in family:
Total household income:
 Housing
1. What is your property type?
O Residential O Commercial O Industrial
If you have two or more on above, please specify.
…………………………………………………………………………………………
2. Do you or rent your home?
O Own home O Rent home
3. How do you feel the collection process of holding tax in your municipality?
O Highly satisfied O Satisfied O Fairly O Less satisfied O Unsatisfied

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4. Do you face any problem for licensing of land property?
O Yes O No
5. Have any project of social housing by Pabna municipality for homeless poor
people like street hawkers, women?
O Yes O No
6. Does your community have any unused building which could be developed for
housing purposes?
O Yes O No
7. What housing issues do you anticipate in the future related to new developments?
O Social housing O Rental housing O own house O others
 Building Plans and Land Use Applications
8. Have you submitted a building plan / land use application in your municipal
authority?
O Yes O No
9. How will you rate the way the municipality approves and enforces building plans and
regulations? In terms of approving and enforcing building plans and regulations?
Strict Good Reasonable Should exert more control Need to be far strict
1 2 3 4 5
10. How do you rate the standard of service delivery of the municipality in respect of
building plans and land use application?
Excellent Good Adequate Inadequate Totally inadequate
1 2 3 4 5
11. Are there any suggestions that you would like to make regarding improving service
delivery in terms of building plans and land use applications?
…………………………………………………………………………………………
…………………………………………………………………………………………
 Education Facility
12. How many schools do you rated in your municipality?
O Less than 10 O 10-15 O 15-20 O More than 20
13. Is your municipality provided any educational facilities?
O Yes O No
If yes, please specify. ……………………………………………………………….

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14. How would you rate the educational facilities in Pabna municipality on a scale of 1 to
5?
Very low Low Moderate High Very high
1 2 3 4 5
15. According to you, is there a difference between the government and private educational
institutes in your municipality and if yes, then what?
…………………………………………………………………………………………
…………………………………………………………………………………………
16. How often did a member of your household make use of a municipal library in the last
3 months?
Never Once Twice At-least 3 Times More than 5 times
1 2 3 4 5
17. In your opinion, are sufficient libraries in your municipal area?
O Sufficient O Insufficient
18. How would you rate the municipal public library service?
Totally Inadequate Inadequate Adequate Good Excellent
1 2 3 4 5
19. Are you satisfied with the quality of service delivery in your library?
O Yes O No
 Health Facility
20. Is your municipality provide any health facilities?
O Yes O No
If yes, Please specify the types of this facility……………………………..
21. How is the condition of health facility?
O Good O Fair O Poor O Very Poor
22. Have any medicine provide by municipality?
O Yes O No
23. Does the municipality provide ambulance or other vehicles to take the patient to the
hospital?
O Yes O No
24. Have any action taken by municipality to remove mosquitoes or other insect?
O Yes O No
25. Are you satisfied with the quality of health service provides by municipality?
O Yes O No

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 Transportation facilities
26. How is the condition of transportation network?
O Good O Fair O Poor O Very Poor
27. How is the road condition?
O Good O Fair O Poor O Very Poor
28. How is the condition of pedestrian facilities?
O Good O Fair O Poor O Very Poor
29. Have enough space for parking lots?
O Yes O No
30. How is the existing condition of parking facilities?
O Good O Fair O Poor O Very Poor
31. When does the traffic congestion generally occur?
O 7.00 A.M. -9.00A.M. O 9.00 A.M.-11.00 A.M
O 5.00 P.M.-7.00 P.M O 7.00 P.M.-9.00 P.M
32. How much accident occurs?
O Mostly often O Often O Sometimes O Rare
33. Please list any suggestions to improve transportation services
…………………………………………………………………………………
…………………………………………………………………………………
 Water supply facilities
34. What is the main source of your drinking water?
O Bore well
O Public tap
O Open well
O Household water supply (piped)
O Others
35. Which of the following sources of water does your household use?
O Hand pump
O Public tap
O Open well
O Household water supply (piped)
O Others

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36. Please answer to the following questions:
Facilities Comments
(if Yes=1,No=2)
Is water available (from your main source) throughout the year?
Is the quantity of water that you receive (from your main source of
water) adequate?
Do you pay for water?
Generally, does the water have a taste?
Is the water supply subject to any treatment or disinfection?
Have any metering system to measure the amount of water?
Have you made a complaint related to your drinking water service in
the past one year?
37. What does the water look like?
O Clear O Cloudy/ dirty
38. In a day, what is the total number of hours of water supply?
O 12 hrs O 16 hrs O 20 hrs O 24 hrs
39. What is your level of satisfaction with piped water supply (all aspects of it)?
O Not satisfied O Dissatisfied O Satisfied O Highly satisfied
40. Is your water supply and distribution system checked/serviced periodically? E.g. are
the storage tanks, pipework and any treatment equipment cleaned and inspected to
ensure they are in good working order?
O Yes O No
 Drainage facilities
41. Is drainage system available in your area?
O Yes O No
42. Please fill up the comment box (Kutcha nali=1, Pucca nali=2, Open=3, underground=4,
Covered with steel grill=5, others=6).
Facilities Comments
What kind of drainage system is it?
What is the state of drainage system within your house?
43. Who maintain drainage system?
O Municipal Committee O Self-maintained O Community O Any others

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44. Please answer to the following questions:
Facilities Comments
(if Yes=1,No=2)
Are the drains blocked by boundary wall?
Are the drains blocked by garbage?
Are the drains cleared regularly?
Is the drainage system sufficient for carrying water of that locality?
Are the water Supply lines passing through the drainage?
 Waste management facilities
45. Is there a waste management facility in your municipality?
O Yes O No
If yes, please explain……………………………………………………................
If no, where does your garbage go? ………………………………………………
46. How is the waste management system?
O Very good O Good O fair O poor
47. What types of waste are generally collected?
O Solid waste O Liquid waste O Both solid and liquid O Others
48. How is the condition of the waste collecting vehicles?
O Very good O Good O fair O poor
49. How is the condition of waste collecting route?
O Very good O Good O fair O poor
50. When the waste is generally collected?
O 7.00 A.M-9.00 A.M
O 10.00 A. M-12.00 P.M
O 2.00 P.M-4.00 P.M
O 5.00 P.M-7.00 P.M
51. Does your municipality have a recycling/dumping facility?
O Yes O No
If yes, what kind(s)?
O Recycling O Dumping O Landfill O Other
If no, would your community be interested in accessing one in the area?
….………………………………………………………………….........

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52. Does the wastage create any pollution?
O Yes O No
If yes, what kind(s)?
O Environmental pollutions
O Water pollution
O Soil pollution
O Odor pollution
O Above all
 Recreational Facility
53. If any recreational facility that provide by Pabna Municipality?
O Yes O No
If yes, specify the kinds of recreational facilities.
54. If yes, how often do you use Pabna Municipality’s recreation facilities?
O Rarely O At least weekly O At least monthly, not weekly O Several times a year
but not monthly
55. Have enough open spaces or green fields?
O Yes O No
56. What is the existing condition of recreational site?
O Good O Moderate O Poor
57. Do you think the parks/playgrounds are safe for children to play in?
O Yes O No
58. How would you rate the extent to which parks and playgrounds in your area are
maintained by the Municipality?
59. In your opinion; are the recreational sites well located, and are they accessible to the
majority of the community?
O Yes O No
60. How would you rate your overall satisfaction with the Pabna municipality’s recreation
facilities?
Highly satisfied Satisfied Fairly Less satisfied Unsatisfied
1 2 3 4 5
Excellent Good Adequate Inadequate Totally inadequate
1 2 3 4 5

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 Power Supply:
61. Can municipal authority fulfill the demand of power supply in the area?
O Yes O No
62. How much price may be paid for per month power supply?
O Good O Moderate O Poor
63. What is the existing condition of power supply in municipality?
O Good O Moderate O Poor
 Fire protection:
64. Have any fire protection system that provided by the municipality?
O Yes O No
Please specify the types of fire protection services……………………………………
65. If Yes, Are you satisfied with the service?
O Yes O No
66. How much fire fighter responsible during fire time?
O Good O Moderate O Poor
67. All the city people are get this services available?
O Yes O No
68. How feel you obstacles are related for fire protection system?
O Very much O Much O As usual O Not at all
 Gas supply
69. Can municipal authority fulfill the demand of gas supply in the area?
O Yes O No
70. How do you feel about the price may be paid for per month gas supply?
O Highly expensive O Expensive O As usual O few
71. What is the existing condition of gas supply in municipality?
O Good O Moderate O Poor
 Security
72. How is the condition of security system of Pabna municipality?
O Good O Moderate O Poor
73. Have any street lighting available beside the road?
O Yes O No

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74. If Yes, how much pay for it?
O Highly expensive O Expensive O As usual O Few
75. How will you rate the responsibility showed by the night guard during their duty
hours?
Not Satisfied 1 2 3 4 5 6 7 8 9 Highly Satisfied
76. How will you rate the overall satisfaction of the following services facility to the
municipality?[ Highly satisfied=1, Satisfied=2, Less satisfied=3, Unsatisfied=4]
Types of Services Highly satisfied Satisfied Less satisfied Unsatisfied
Education facility
Transportation facility
Water supply
Power supply
Fire protection
Drainage system
Gas supply
Health facility
Recreational facility