TRANSMITTA L o f OMAH A LEA D SIT E PAIN T STABILIZATIO N FIL E FOLDE R SAID# : c^fs^ S Date : Afjnf>.J2.aJr ^ Address : /^/ ^ S!p^,^rc r

S h Stabilizatio n Contractor : Pruden t Technologies , Inc . Year : 2010 _ PAIN T STABILIZATIO N PROPERT Y FIL E FOLDE RDOCUMENT S ^ Vide o o f propert y (DVD ) Org
- gA ^ pOS T I v Executiv e Summar y mSigne dAcces s Agreemen t fo r subjec t propert y B Pre-Renovatio n For msigne db y Propert y Owne r D Pre-Renovatio n For mfo r Occupant/Tenant , i f applicabl e 0 Paintin g Agreemen t D Settlemen t document s (i.e. , fo r damag e o r t o replac e plants , etc. ) 5

f Renovatio n Recordkeepin g Checklis t signe db y Certifie dRenovato r ^ Photograph s y Satisfactor y close-ou t chec k lis t signe db y Propert y Owne r D Propert y close-ou t chec k lis t signe db y EP A y Propert y informatio n fromDougla s Coimt y Assessor' s Offic e g f

Hazar danalysis , i f prepare d D Safet y Audi t 3020382 3 D Othe r (describe) : 

# nm Superfun d

EP A CO RSignatur e TJat e (afte r file folde r review )TBCHNOLOCIBS . 1 

## Propert y Summar y Date : 07/8/201 0 | LB P STABILIZATIO N EP A CONTRAC T EP-R7-08-0 7 | Mont h of : Jul y Propert y Address ; 146 5 Spence r S t SAI D # : 3066 5 A . Executiv e Summary : a . Issue s Encountered : NON E b . Issue s Resolved : NON E c . Uniqu e Findings : NON E d . Othe r Relevan t Information : i . Acces s Date : 04/26/201 0 ii . Wor k Began : 05/28/201 0 iu . Close-Ou t Date : 05/28/201 0 B . Enclosures : 1 . Pre-Stabilizatio n Vide o 2 . Post-Stabilizatio n Vide o 3 . Signe dAcces s Agreemen t Form 4 . Advance-Notic e For m 5 . Pre-Stabilizatio n Vide o Agreemen t Form 6 . Acces s Trackin g For m 7 . Propert y Acces s Assessment Form 8 . Neighbo r Acces s Agreemen t Form 9 . Propert y Pain t Matc h Form 10 . Pre-Stabilizatio n Propert y Safet y Assessment Form 11 . Work-Sit e Hazard s Analysi s Checklis t 12 . Pre
- Stabilizatio n Propert y Hazar dAssessment Photograph s 13 . Dougla s County Assesso r Propert y Informatio n 14 . Signe dPropert y Completio n Agreemen t Form 15 . Propert y Close-Ou t Chec k Lis t Signe dB y EPA^SCHNOLOGIBS , IN C Pruden t Technologies , Inc . (Prudent ) i s unde r

contrac t (Contract #EP-R7-08-07 ) wit h the U . S . Enviroiraienta l Protectio n Agency (EPA) to stabiliz e Lea dBasedPain t (LBP) a t animibe r

o f propertie s locatedin Omaha , Nebraska , including tiie propert y locate dat : ) ^ ^ < ; ^ p^.j^ r c-r ~ Sj ^ Th e EP A request s you r

permissio n to allo w Pruden t to perfor mLB P Stabilizatio n a t thi s property . B y signing thi s form, th e propert y owne r

grant s permissio n to Pruden t t o perfor mactivitie s relate dt o LB P Stabilizatio n including scraping paint an dpaintin g o f th e referencedproperty . Further , th e owner/tenan t verifie s tha t the y hav e receive dthe LB P pamphle t "Renovat e Right. " B y signing thi s documen t I agre e to allo w a n EP A contractor to conduct asoi l cleanu p a t m y propert y followin g completio n o f lead-basedpain t stabilization , i f the soil cleanu p ha s no t alread y been performed . I understandtha t the stabilizatio n contractor cannot provide assurance s o f which contractor will b e boun dt o th e soi l cleanup . I furthe r

understandtha t th e soi l cleanu p contractor will mak e all reasonabl e efforts to addres s concem s tha t I , a s the propert y owner , ma y hav e regardin g soil cleanu p a t m y property . [ ^JYes , I hav e rea dan dunderstandth e paragraph above .

I Propert y Owner' s Signatur e Dat e I f

yo u hav e an y question s abou t the LB P stabilizatio n plannedfo r

you r

property , pleas e contact Prudent' s Custome r

Relations/Offic e Manage r

fo r

the Lea dBasedPain t Stabilization , Mr . Chandr a Shekar a

t 402
- 504-100 4 o r 402-889-3821 . Genera l question s abou t the OmahaLea dSit e cleanu p ca n b e directe dto the EP A Publi c Information Center s a t (402 ) 731-304 5 (Sout h Omahaoffice) or (402 ) 991-958 3 (Nort h Omahaoffice) . Propert v Acces s Grante dBv : V - ^ ^ -^oyf a I T5'rrvt^o-t*f^ 7 r^\Trr»<ai*' e QirmQ+ii-r o Propert y Owner' s Signatur e Dat e 

# h £CVU: A 

## ^
- <^'^rj&S< , leas e Prin t Nam e

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone:(816)363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax:(816)363-370 7 Fax : (402)504-100 5 Fax:(210)579-657 7TBCHNOLOGIBS . INC . PROPERT Y INFORMATIO N (T o b e complete db y residen t and/o r propert y owne r —pleas e print ) 

## : ^oVu? e Iv ^ W L . 

## fi> Tenan t RESIDEN T NAME : xC . 

## \ . \>SUY-Cig.^ ^ RESIDEN T ADDRESS : JM^S " Sv''-^'^*' ^ ^^ ^ 

## r>^7^V> A K3e . C.<^\ \o I FRENTAL , PROPERT Y OWNE D BY : OWNER' S MAILIN G ADDRESS : So^r^y ^ OWNER' S TELEPHON E NUMBER : Home : Mo2 ^ fe<M ~\?t,^ork:_ Cell : NUMBE RO FOCCUPANTS UNDE R7 YEAR S OLD : TOTA L NUMBE RO FOCCUPANTS : NUMBE RO FCHILDRE N UNDE R7 YEAR S OL D WH O PLA Y I N TH E YAR D FOR5 HOUR S O

RMOR E PE RWEEK : ^Oj i COMMENT S O RSPECIA L INSTRUCTION S (suc h a s dogs , entr v gates , etc.) :

AUTHORIT Y FO RENVIRONMENTA L RESPONS E ACTIONS : Th e activitie s to b e implemented by EP A unde r

thi s agreemen t ar e pursuan t to Section 10 4 o f CERCLA , 4 2 U.S.C . 9604 . EPA' s righ t of

acces s to th e propert y i s provide dfo r

in Section 104(e ) of CERCLA , 4 2 U.S . C 9605(e) , which provide s entr y fo r

"determinin g the needfo r

response , o r

choosing o r

takin g an y respons e actio n unde r thi s title , or otherwis e enforcing th e provision s of th e title. " Propert y Owne r

Signature : 9\jJXku y ^ S^UA^y ^ X (Signature ) Dat e 808 0 War dParkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medical Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7

# f

/ slAiiMd . 

### PR E & POST PAIN T STABILIZATIO N VIDE O AN D PICTURE S 1 understan d tha t pruden t Technologie s (Prudent ) wil l b e comin g ou t t o shoot a Pre Stabilizatio n vide o an d t o tak e picture s o f m y property . Pruden t wil l us e th e video s an d picture s t o documen t th e curren t propert y status/condition . Also , Pruden t wil l shoo t a vide o shot followin g th e completio n of th e pain t stabilization . I giv e permissio n t o video s an d picture s o f m y property . Pleas e lis t an y specia l condition s that Pruden t employee s nee d t o b e awar e of before shootin g a vide o (suc h a s pets , prio rnotice , etc.) . 

### \MC, S perV- \ LJ£J C 

### AKJ ^ Qm^Ln . KV. ^ e^^\(X > Propert y Addres s Owner' s Nam e Signature Dat e 

### ADVANC E NOTIC E REQUIREMEN T Afte rsignin g th e acces s yo u allo w Pruden t t o begi n Lead Base d Pain t Stabilization . Al l Plants , weed s an d an y vehicle s o ritem s o n ope n porc h (enclose d porche s wil l NO T b e stabilized ) mus t b e remove d prio rt o stabilization . Al l Pets mus t b e ou t o f yar d durin g stabilization . Pleas e indicat e below ho w muc h advance notic e yo u nee d t o hav e th e above mentione d task s completed . I f yo u are a landlor d yo u wil l nee d t o contac t th e tenan t as Pruden t wil l onl y infor m th e propert y owners . Do yo u have an y pets tha t resid e i n yard : JJA . Notic e needed : __ ^ Phon e numbe rt o cal l t o giv e notice : Who m w e are givin g notic e to :

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7

# Curren t Sampl e Pre-Renovatio n For m Effectiv e unti l Apri l 2010 . Confirmatio n of Receip t of Lea d Pamphle t •I hav e receive d a cop y of th e pamphlet , Renovate Right : Importan t Lea d Hazar d Informatio n fo r Families , Chil d Car e Provider s an d School s informin g me of th e potentia l ris k of th e lea d hazar d exposur e fro m renovatio n activit y tobe performe din my dwellin g unit . I receive d thi s pamphlet befor e th e wor k began . 

### V-—cih--^^^^^' 6 ' Printe d nam e of recipien t tDate Signatur e

of recipien t Self-Certificatio n Optio n (fo rtenant-occupie d dwelling s only ) — If th e lead pamphlet wa s delivere d bu t a tenan t signatur e wa s not obtainable , yo u ma y chec k th e appropriat e bo xbelow . •Refusa l to sig n —I certif y that I hav e mad e a goo d fait h effor t to delive rth e pamphlet , Renovate Right : Importan t Lea d Hazar d Informatio n fo rFamilies , Chil d Car e Provider s an d Schools , to th e renta l dwellin g uni t liste d below at th e dat e an d tim e indicate d an d that th e occupan t refuse d to sig n th e confirmatio n of receipt . I furthe rcertif y that I hav e lef t a cop y of th e pamphlet at th e uni t wit h th e occupant . •Unavailabl e fo rsignatur e —I certif y that I hav e mad e a goo d fait h effor t to delive rth e pamphlet , Renovate Right : Importan t Lea d Hazar d Infomnatio n fo r Families , Chil d Car e provider s an d Schools , to th e renta l dwellin g uni t liste d below an d that th e occupan t wa s unavailabl e to sig n th e confirmatio n of receipt . I furthe rcertif y that I hav e lef t a cop y of th e pamphlet at th e uni t by slidin g it unde rth e door . Printe d nam e of perso n certifyin g Attempte d deliver y dat e an d tim e lea d pamphlet deliver y Signatur e

of perso n certifyin g lead pamphlet deliver y

Uni t Addres s Not e Regardin g Mailin g Optio n — As an alternative to deliver y

in person , yo u ma y mai l th e lead pamphlet to th e owne rand/o rtenant . Pamphlet mus t be maile d at leas t 7 day s befor e renovatio n (Documen t wit h a certificat e of mailin g fro m th e pos t office) .

# m raer PAIN T MATCHIN G FORM : 1 . T O B E FILLE D OU T ONL Y I F MATCHIN G COLO R PROPERT Y ADDRESS : BVID : 

### \ M fa ^ Qpp.^ e ^y ^ 6 8:/3"t , Th e followin g note s ar e fo r th e benefi t o f pam t cre w only . Locatio n Pain t Descriptio n Pain t Ye s Pain t N o Siding Soffi t Fasci a 

# V\^ \ Utr®<f t 

## W^ A 

# y ^

Come r Tri m ^C^Dc P Windo w Trim s ^LASOPC ^ Doo r Trim s Fron t Porc h Ceiling Fron t Porc h Ceilin g Beams Fron t Porc h Floo r 

### i^(n>-d
B "e^^eJlff l <> ^J l £j^( y 

## ^\< A eJrusSicfir^^A ^ Xy " \y ^ Fron t Porc h Railing s Fron t Porc h Step s Siding Baseboard s <e>ju- g 

### Jurt-^.c^ , pen ? c ^

( fOp f pcx^A ^ ye^ J f- ^ \ y

Foundation 

## joJ^ K ^ 

# fir^cjfc^ (mx ^ VOC5>P<5 L 

# dL- L\poa^^ ^ y y

^

• I UNDERSTAN D SHERWI N WILLIAM S WIL L MATC H M Y CURREN T COLORS . jLooUt^J U z&UfiiU ^ Homeowne r signature : 

### Date : y-^6-^<^^' ^ 

# H ^ 808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax:(210)579-657 7;iN C ACCES S ASSESSMEN T FORM : I s th e propert y stucc o o rasbestos ? I f yes , i s an y o f th e stucco o rasbesto s damage d o r cracked ? I f yes , sto p a s w e can' t stabiliz e thi s property . I t require s specia l preparatio n techniques . I t wil l b e returne d t o EP A an d the y wil l assig n at a late rdate . Doe s thi s propert y require lot s o f scrapping ? Doe s thi s propert y require a lif t o rscaffoldin g t o reac h uppe rlevels ? Doe s thi s propert y have lot s o f plant s o ritem s i n area s where paintin g i s required ? Doe s thi s propert y have an y significan t structura l damage ? I f yes , EXPLAIN ? Doe s thi s propert y have a garage ? I f yes , describ e locatio n o f garage . Doe s thi s propert y have aluminu m siding ? I f yes , i s i t origina l factor y finis h o rhas i t bee n painte d over ? Doe s thi s propert y have an y othe rtyp e of structura l components ? (I.e . roof shingle s a s siding) ? I f yes , EXPLAIN ? I s thi s propert y vacan t o roccupied ? Ar e ther e an y pet s a t thi s property ? Are ther e an y lo w hangin g powe rlines ? Do we nee d neighbor' s access ? I f ye s pleas e explai n an d ge t neighbor' s propert y addres s an d owne r information . I f possible , ge t signature fro m th e neighbor . 

# AJdrfy-v l ) ^ - \ 

## fLy o i^ ^ 

## M 0 NJc ) 

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# y

0 CCJLK^ X e- ^ 

# fo o Ye ^

V . 

## f<J O

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 Sa n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax : (210 ) 579-657 7TECHNDUXSIES^INC . 

### ACCES S INFORMATIO N TRACKIN G SHEE T BVID : PROPERT Y ADDRESS : Propert y Owne dBy : -il-VA.Uft^ f L D^.c q €.^nr^ 

# ^3 (If ne w propert y owner )

Owner s Phon e No's : Home :'?±4r.ii.1r.L^^ork : Fax : — Cell : Acces s Contractor : AS W PD A ME S P E Othe r (Prudent ) DATE TIM E ACCESSO R CONRAC T DETAI L «^-^ S KOL*-- ^ I-<S L 

### ^r^^.jJK'Jll . 

# H h

Comments :

808 0 War d Parkway , Suit e 40 5 250 5 N . 24' " Street , Suit e 30 8 424 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 San Antonio , T X 7822 9 Phone:(816)363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax:(816)363-370 7 Fax : (402)504-100 5 Fax:(210)579-657 7(effectiv e Apri l 2010 ) RENOVATIO N RECOS^KEEPIN G CHECKLIS T Nam e of Firm : •dA i 

# t Dat e an dLocatio n of Renovation : S^OS ^ "/i ^ //^-S^^^Ofy^sg/^
- J/ " Brie f

Descriptio n o f Renovation : fypjOfj A Nam e of AssignedRenovator : . . Name(s ) o f Traine dWorkers : j/Jf^.^f'j^'2/r? 7 /zixtMU-y ^ . y ^ A^y ^ (jC^uJUi-eH) . .ffli^Wy^.^>a ^ Nartie of Dus t Sampling Technician , Inspector , and/or Ris k Assessor , i f used : D Copie s of renovator anddus t sampling technicia n qualification s (trainin g certificates , certifications ) on file. 0^l5ertifie drenovator provide dtrainin g t o worker s on (chec k

all that apply) : E-P^in g warning sign s ^-Settin g u p plasti c contaiimien t barrier s CUMaintainin g containmen t Q-Avoidin g sprea do f dus t t o adjacen t area s H'^^t e handling B'i'ost-renovatio n cleanin g D Tes t kit s usedby certifiedrenovator t o determine whethe r

lea dwa s present on component s affecte dby renovation (identif y kit s usedanddescrib e sampling location s andresults : 0^amin g sign s posteda t entranc e to wor k

area . B'^Wor k

are acontaine dto preven t sprea dofdus t anddebris . [zKwindows in an dwithin 2 0 fee t o f the wor k

are aar e closed CHJoor s U l an dwithin 20 fee t of th e wor k

area s ar e close dandsealed Q Dopr s tha t mus t b e use di n th e wor k

are aar e covere dto allo w passag e but preven t sprea dofdust . Eijroun dcoveredby plasti c sheeting extending 1 0 fee t fi-omwor k

are a- plasti c anchore dto the buildin g an dweighteddow n b y heavy objects . p I f

necessary , vertica l containmen t installe dto preven t migratio n ofdus t an ddebri s to adjacen t /property . [ j Wast e containedon-sit e an dwhil e being transporte doff-site .

Renovatio n Recordkeepin g Checklis t Omah a Lea d Sit e(effectiv e Apri l 2010 ) Q^^Wor k

sit e properl y cleane dafter renovation . [jkAl l chip s an ddebri s picke dup , protectiv e sheetin g misted , folde ddirty sid e inward , an dtape d for removal . 7or k

are aHEP A vacuume dt o ge t pain t chip s fi-omgroim dsurface , i f necessary . D Certifie drenovato r performe dpost-renovatio n cleanin g verificatio n (describ e results) :

I certif y unde r penalt y o f la w tha t th e above infomiation i s tru e an dcomplete . 

## ^' ^ :>Sy S Nam e an dTitle Dat e

Renovatio n Recordkeepin g Checklis t Omah a Lea d Sit eTECHNOIiOGIES , IN C 

### Checklis t fo r th e Worksit e Hazar dAnalysi s . Address : Crew : Ite m I OK ? i , ^ Hpar i Correctiv e Actio n Overhea dLine s In-transi t Vehicl e Clearanc e Level s aroun dhigh wire s Vehicl e Clearanc e around hig h wire s whe n workin g Phon e line s Cabl e line s Ga s Lin e Wate r Lin e Sewe r Lin e Septi c Tan k Propane/Butan e Acces s to/o n Propert y/ ^ 

# terfep encBA ^ Neighbo r Acces s Require d^ Vx2 3 Hig h Traffi c Are a Garag e 

### iCu > 

# ;=T2 ^ Structure s -U l 

### ^ nt>ll^A.)&tyz^^n~y^v ^ l^^pciA \ - ^ Drivewa y 

# Ti m l^LL l Sidewalk 

# /^ ^ P^ff'T^ ti f dM L t x

-fp-n ^ -hrcna f \lI3b^d ^ Foundatio n Retainin g Wall s n J O Fence s Tree s Foliage-S^^liy.^ / jy ^ ,^:i ^ Genera l Conditio n i 

### "/"trotki t b&^^'yep ii^'rvJiz^4^\'^ ^ Damage dAreas : sink ^— j ^ ~^'7\ | ' b 7"

—7 ' " ^ ^ holes/rotte dwoo d\}>t ^ ^ i^&- ^ C^H'^i ^ hdcCv^f ^ T V c ' c// ? Sprinkle r Syste m Pet s Insect s Weathe r Condition s Unsaf e drivin g condition s 

# ^"^X^kW i V M A S^ ^ -O ^ - ^ ^"^ ^ Foreman / Sjib-dontracto r Office r

808 0 War d Parkway , Suit e 40 6 250 5 N . 24* " Street , Suit e 30 8 f 24 2 Medica l Drive , Suit e 425 0 Kansa s City , M O 6411 4 Omaha , Nebrask a 6811 0 i n Antonio , T X 7822 9 Phone : (816 ) 363-370 3 Phone : (402)504-100 4 Phone : (210)822-958 8 Fax : (816 ) 363-370 7 Fax : (402)504-100 5 Fax:(210)579-657 7" •

— '—-- — t 

### y:^y^.!i ^ 

# i

• n 

# 1 D-(5:^-V r • TECHNOLOGIES , INC . OMAH A LEA D BASE D PAIN T REMEDIATIO N Propert y Owne r Close-Ou t For m 201 0 (Lead-BasedPain t Stabilizatio n EP A Contract EP-R7-08-07 ) SAID : 

## J^^<r ^ Propert y Address : /^ ^ ^ y/^/^y\AZ^l( ^ ^7 7 Owner' s Name : /PC/r-j^/ ^ ^L/^/^^.^i ^ Performanc e Standards/Close-Ou t Criteri a 1 . Wa s th e entir e structure(s ) painte dwith th e exceptio n o f th e stated , exclude dareas ? Thi s woul dinclud e paintin g o f othe r associate dfeature s includin g fascia , eaves , siding , al l trim , porches , bo x beams , columns , rails , an dexterio r surface s o f garages . 2 . Wa s al l scrapin g an dothe r preparatio n wor k

complete dsatisfactorily ? 3 . Were al l require darea s o f th e structure(s ) prime da s neede dan dpainte dwith tw o to p coats ? 4 . Wa s th e pain t product s utilize dequivalen t t o a2 5 year product/quality ? 5 . Ar e al l o f th e area s wher e contaminate dmaterial s hav e bee n spille dthoroughl y vacuumed / cleaned ? 6 . Di dth e contracto r collect/vacuu mal l fallin g an dscrape dpain t chip s o n th e entir e property , roadways , alleyways , publi c acces s area s an dals o remov e an y othe r generate ddebris ? 7 . I s th e grass are athat surround s th e structure(s ) i n reasonabl y goo dcondition ? 8 . Are al l item s suc h a s polyethylen e sheeting , ladders , pain t brushes , cones , barrie r tape , etc . properl y removed ? 9 . I s ther e an y evidenc e o f property damag e that wa s don e b y th e contractor ? An y property damag e need s t o b e complete dprio r t o th e EP A Close-Out . 10 . Ar e yo u satisfie dwith th e wor k

performed ? 11 . Ar e ther e any property item s tha t wer e temporaril y re-locate db y th e contracto r that nee d t o b e move dback ? 12 . Ar e ther e an y (known ) lingerin g issue s with th e property owner(s ) tha t hav e bee n lef t unresolved ? Othe r Considerations/Property Owne r Discussions/Additiona l Wor k

thati s Required :

k

L 

## 7/^. ' y ^ \i')ci\p^^^ ^ Propert y Owne r

Signatur e Dat e Pruden t Technologies . Inc . Signatur e Dat e -:j.-, 2 ivisuira ' :-/ : ; . : YE S N O

r .

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#• < ^ tDougla s County Accoun t Infomiatio n Pag e 1 of 2 Dougla s County , Nebrask a Propert y Recor d - R224950000 0 Prin t Reoor t NE W Featur e - Parce l Dimension s availabl e & . scal e 0-5 0 f t wes t of 52n d S t - VIG W O n Ma P Informatio n i s vali d a s o f 2010-3-1 6 Treasurer' s Ta xRepor t Ne w Featur e - » r¥ . • • Aut o Sale s Searc h Owne r BURGES S RUTHI E L 146 5 SPENCE R AV E OMAH A N E 68110-000 0 Propert y Informatio n Ke y Number : 495 0 000 0 2 2 Accoun t Type : Residentia l Parce l Number : 224950000 0 Parce l Address : 146 5 SPENCE R S T OMAH A N E 68110-000 0 Lega l Description : SULPHU R SPRIN G LO T 4 BLOC K4 5 0 X 12 4 Valu e Informatio n Lan d Improvemen t Tota l 200 9 200 8 200 7 200 6 200 5 200 4 $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0 $2,600.0 0 $26,700.0 0 $26,700.0 0 $26,100.0 0 $26,100.0 0 $26,100.0 0 $9,800.0 0 $29,300.0 0 $29,300.0 0 $28,700.0 0 $28,700.0 0 $28,700.0 0 $12,400.0 0 Sale s Informatio n Sale s Date : 2003-06-2 6 Dee d Type : Q C Book : 200 3 Page : 12128 6 Price : $0.0 0 Grantor . ROBER T BURGES S Grantee : RUTHI E BURGES S Valid/Invalid : Invali d Exclusio n Reason : Famil y Sal e Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.1 4 6200. 0 1. 0 124. 0 50. 0 N o Improvemen t Informatio n
http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R224950000 0 3/23/201 01 Dougla s Count y Accoun t Informatio n Pag e 2 of 2 Buildin g 1

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Buil t As :

HVAC : Exterior : Interior : Roo f Cover :

Roo f Type : Floorcover : Yea rBuil t 1165. 0 0. 0 2 1/ 2 Stor y Unfi n Force d Ai r Fram e Viny l Drywal l Compositio n Shingl e Hi p Allowanc e Yea r Remodele d 190 7 0 Detai l Typ e Applianc e Applianc e Basemen t Fixtur e Fixtur e Porc h Porc h Use r 1 1

Percen t Remodele d 0 % Defai Y Descriptio n Allowanc e Securit y Syste m Bsmn t Bloc k 8 f t Bas e Fixture s Bat h Ful l En d Soli d Wal l En d Soli d Wal l Se e note s t4e5S(wnM f Swwdne w

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CLIC KT O ENLARG E IMAG E Percen t Complete : Quality : Condition : Cond o Squar e Footage : Rooms :

Units : Baths : Bedrooms : Stories : Foundation : Sprinkle rSquar e Footage : Adjuste d Yea r 100.0 % Averag e Averag e 0. 0 6. 0 1. 0 1. 0 3. 0 2. 5 Bloc k 0. 0 Physica l Ag e Buil t 190 7 10 3 Unit s 1. 0 1. 0 572. 0 1. 0 1. 0 44. 0 176. 0 1. 0

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