TRANSMITTAL of OMAHA LEAD SITE 

PAINT STABILIZATION FILE FOLDER 

SAID#: ^l^Rfaj Date: fi|X)q. |aoi n 

Address: ,^^* r Nir4WA< St . 

Stabilization Contractor: Pruden t Technologies, Inc . Year: 2010_ 

PAINT STABILIZATION 

PROPERTY FILE FOLDER DOCUMENTS 

E^ Video of property (DVD) 

Si Executive Summary 

W Signed Access Agreement for subject property 

^ Pre-Renovation Form signed by Property Owner 

D Pre-Renovation Form for Occupant/Tenant, if applicable 

\ y Painting Agreement 

D Settlement documents (i.e., for damage or to replace plants, etc.) 

s Z Renovation Recordkeeping Checklist signed by Certified Renovator 

S/ Photographs 

fi^ Satisfactory close-out check list signed by Property Owner 

B^ Property close-out check list signed by EPA 

Q^ Property information from Douglas County Assessor's OfBce 

w Z Hazard analysis, if prepared 

D Safety Audit 30260024 

• (MerrdescH..: illinil 

Superfunc 

PrudSit Te(;hno'logy/mcr Signature i\Sws 

(after file folder review) 
TECHNOLOGIBS, 1 

Property Summary 

Date: 6/24/2010 LBP STABILIZATION EPA CONTRACT EP-R7-08-07 Month of: June 

Property Address: 3025 Nicholas St. SAID #: 24861 

A. Executive Summarv: 

a. Issues Encountered: NONE 

b. Issues Resolved: NONE 

c. Unique Findings: NONE 

d. Other Relevant Information: 

i. Access Date: 03/30/2010 

ii. Work Began: 04/12/2010 

iii. Close-Out Date: 04/12/2010 

B. Enclosures: 

1. Pre-Stabilization Video 

2. Post-Stabilization Video 

3. Signed Access Agreement Form • 

4. Advance-Notice Form 

5. Pre-Stabilization Video Agreement Form 

6. Access Tracking Form 

7. Property Access Assessment Form 

8. Neighbor Access Agreement Form 

9. Property Paint Match Form 

10. Pre-Stabilization Property Safety Assessment Form 

11. Work-Site Hazards Analysis Checklist 

12. Pre- Stabilization Property Hazard Assessment Photographs 

13. Douglas County Assessor Property Information 

14. Signed Property Completion Agreement Form 

15. Property Close-Out Check List Signed By EPA 
4afLOCIBS, IN C 

Prudent Technologies, Inc. (Prudent) is under contract (Contract # EP-R7-08-07) with the U. S. 

Environmental Protection Agency (EPA) to stabilize Lead Based Paint (LBP) at a number ofpropcrties 

located in Omaha, Nebraska, including the property located at: 

3^P. 5 hfVc|.g>l<a^ <;f 

The EPA requests your permission to allow Prudent to perform LBP Stabilization at this property. By 

signing this form, the property owner grants permission to Prudent to perform activities related to LBP 

Stabilization including scraping paint and painting ofthe referenced property. Further, the 

owner/tenant verifies that they have received the LBP pamphlet "Renovate Right." 

By signing this document I agree to allow an EPA contractor to conduct a soil cleanup at my property 

following completion of lead-based paint stabilization, ifthe soil cleanup has not already been 

performed. I understand that the stabilization contractor cannot provide assurances of which 

contractor will be botmd to the soil cleanup. I further imderstand that the soil cleanup contractor will 

make all reasonable efforts to address concems that I, as the property owner, may have regarding soil 

cleanup at my property. 

fxl Yes, I have read and imderstand the paragraph above. 

V^A 'Z^/ 

Property Owner's Signature Date 

Ifyou have any questions about the LBP stabilization plaimed for your property, please contact 

Prudent's Customer Relations/Office Manager for the Lead Based Paint Stabilization, Mr. Chandra 

Shekar at 402- 504-1004 or 402-889-3821. General questions about the Omaha Lead Site cleanup can 

be directed to the EPA Public Information Centers at (402) 731-3045 (South Omaha office) or (402) 

991-9583 (North Omaha office). 

Propertv Access Granted Bv: 

Toperty Owner's Signature Date 

y^/?//zzS X/i/A 

Please Print Name 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 IMedical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax:(210)579-6577 
Tmn TBCHNOLOCIBS, IN C LfHil 

PROPERTY INFORMATION 

(To be completed by resident and/or property owner — please print) 

RESIDENT NAME: Anrtt^< ; f^\\\J(K (.Owner Tenant 

RESIDENT ADDRESS: r\ D K A ) i r Jn olo s S f 

Cn)aln^ AlE &^iM 

IF RENTAL, PROPERTY OWNED BY: 

OWNER'S MAILING ADDRESS: 

OWNER'S TELEPHONE NUMBER: 

Home: lQb2\70'\'^57JWoTk: Cell: yO^-S^O ^ 

NUMBER OF OCCUPANTS UNDER 7 YEARS OLD: O iLnU j Jlu^. 'Xjne . 3 l0)0 j 

TOTAL NUMBER OF OCCUPANTS: _2 . 

NUMBER OF CHILDREN UNDER 7 YEARS OLD WHO PLAY IN THE YARD FOR 5 HOURS 

OR MORE PER WEEK: jl^aL j Au €, Tu)r^r. ?,j JoLO') 

COMMENTS OR SPECIAL INSTRUCTIONS (such as does, entry gates, etc.); 

AUTHORITY FOR ENVIRONMENTAL RESPONSE ACTIONS: The activities to be implemented 

by EPA under this agreement are pursuant to Section 104 of CERCLA, 42 U.S.C. 9604. EPA's right 

ofaccess to the property is provided for in Section 104(e) of CERCLA, 42 U.S. C 9605(e), which 

provides entry for "determining the need for response, or choosing or taking any response action under 

this title, or otherwise enforcing the provisions ofthe title." 

Property Owner Signature: 

(Signature) Date 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
"nCHNGILOGIBai,INC 

PRE & POST PAINT STABILIZATION VIDEO ANP PICTURES 

I understand that prudent Technologies (Prudent) will be coming out to shoot a PreStabilization video and to tal<e pictures of my property. Prudent will use the videos and 

pictures to document the current property status/condition. Also, Prudent will shoot a video 

shot following the completion of the paint stabilization. I give permission to videos and 

pictures of my property. 

Please list any special conditions that Prudent employees need to be aware of before 

shooting a video (such as pets, prior notice, etc.). 

:^Aa^ M\rhr>la^ ,9/. nr>,ahA NF. &EI3I 

Property Address 

An/drPS .ClvJQ 

Owner's Name Signature ^afe 

ADVANCE NOTICE REQUIREMENT 

After signing the access you allow Prudent to begin Lead Based Paint Stabilization. All 

Plants, weeds and any vehicles or items on open porch (enclosed porches will NOT be 

stabilized) must be removed prior to stabilization. All Pets must be out of yard during 

stabilization. Please indicate below how much advance notice you need to have the abovementioned tasks completed. If you are a landlord you will need to contact the tenant as 

Prudent will only inform the property owners. 

Do you have any pets that reside in yard: hJQ 

Notice needed: I —D. rJlQuS 

Phone number to call to give notice: '~/0^~ 3CoO^ 

Whom we are giving notice to: KCXT\€^ S\\\/( K 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
Current Sample Pre-RenovSion Form 

Effective until April 2010. 

Confirmation of Receipt of Lead Pamphlet 

j£ j have received a copy of the pamphlet, Renovate Right: Important Lead Hazard 

Z Infomnation for Families, Child Care Providers and Schools informing me of 

the potential risk of the lead hazard exposure from renovation activity to be 

performed in my dwelling unit. I received this pamphlet before the work began. 

Printed name of replpient ^ Date 

Signature of recipient 

Self-Certification Option (for tenant-occupied dwellings only) — 

If the lead pamphlet was delivered but a tenant signature was not obtainable, 

you may check the appropriate box below. 

• Refusal to sign — I certify that I have made a good faith effort to deliver the 

pamphlet, Renovate Right: Important Lead Hazard Infomnation for Families, 

Child Care Providers and Schools, to the rental dwelling unit listed below at the 

date and time indicated and that the occupant refused to sign the confirmation 

of receipt. I further certify that I have left a copy of the pamphlet at the unit with 

the occupant. 

Q Unavailable for signature — I certify that I have made a good faith effort to 

deliver the pamphlet, Renovate Right: Important Lead Hazard information for 

Families, Child Care providers and Schools, to the rental dwelling unit listed 

below and that the occupant was unavailable to sign the confirmation of receipt. 

I further certify that I have left a copy of the pamphlet at the unit by sliding it 

under the door. 

Printed name of person certifying Attempted delivery 

date and time 

lead pamphlet delivery 

Signature of person certifying lead pamphlet delivery 

Unit Address 

Note Regarding Mailing Option — As an alternative to delivery in person, you 

may mail the lead pamphlet to the owner and/or tenant. Pamphlet must be mailed 

at least 7 days before renovation (Document with a certificate of mailing from the 

post office). 
SDSLINC. 

PAINT MATCHING FORM: 

1. TO BE FILLED OUT ONLY IF MATCHING COLOR 

PROPERTY ADDRESS: 3/0^ 5 )\f.^/-k/of.a<=^ J> t 

BVID: 

The following notes are for the benefit of paint crew only. 

Paint Yes Paint No Location Paint Description 

Siding ^ 

Soffit i ^ 

LAI209 Forest 3 

Fascia y 

Comer Trim io^ 5 U<C:M^^ u ^ 

Window Trims u ^ 

Door Trims z^{dC^ Cis[oc u ^ 

Front Porch Ceiling «x 

Front Porch Ceiling Beams ^ 

Front Porch Floor ^ 

Front Porch Railings t / ' 

Front Porch Steps t ^ 

Siding Baseboards w ^ 

Foundation Cjz^^ry\er\\' 

sX (j)r^Cir^P 

^^a.r \:>pr\c - ^ 

• I UNDERSTAND SHERWIN WILLIAMS WILL MATCH MY CURRENT COLORS. 

Homeowner signal 

8080 Ward Parkway, Suite 405 

Kansas City, MO 64114 

Phone: (816) 363-3703 

Fax: (816) 363-3707 

2505 N. 24*^ Street, Suite 308 

Omaha, Nebraska 68110 

Phone: (402)504-1004 

Fax: (402)504-1005 

4242 Medical Drive, Suite 4250 

San Antonio, TX 78229 

Phone: (210)822-9588 

Fax: (210) 579-6577 
m 

IKHNOUXnBSb INC 

ACCESS ASSESSMENT FORM: 3 ^ "2-5

Is the property stucco or asbestos? 

If yes, is any of the stucco or asbestos damaged or 

cracked? 

If yes, stop as we can't stabilize this property. It 

requires special preparation techniques. It will be 

returned to EPA and they will assign at a later date. 

Does this property require lots of scrapping? 

Does this property require a lift or scaffolding to reach 

upper levels? 

Does this property have lots of plants or items in areas 

where painting is required? 

Does this property have any significant structural 

damage? If yes, EXPLAIN? 

Does this property have a garage? 

If yes, descritje location of garage. 

Does this property have aluminum siding? If yes, is it 

original factory finish or has it been painted over? 

Does this property have any other type of structural 

components? (I.e. roof shingles as siding)? 

If yes, EXPLAIN? 

Is this property vacant or occupied? 

Are there any pets at this property? 

Are there any low hanging power lines? 

Do we need neighbor's access? If yes please explain 

and get neighbor's property address and owner 

information. If possible, get signature from the 

neighbor. 

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8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 

Fax:(816)363-3707 

Phone: (402)504-1004 

Fax: (402)504-1005 

Phone: (210)822-9588 

Fax: (210) 579-6577 
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S^S^'L - ^•^^r-: ^ f\l\^ -X^^Q^^, ^ 
(effective April 2010) 

RENOVATION RECORDKEEPING CHECKLIST 

Name of Firm: ^ 

Date and Location of Renovation: AP J ^ xJ^O^^CA ^ ^ ^ 

Brief Description of Renovation: ^ ^ f^^A^D \V^ ^0\.\f^'\^C^ 

Name of Assigned Renovator: C-AStv.'^ ^^g'^POQ 

Name(s) of Trained Workers: J^j ^ .^AtVUl/li ^rj^l^i^ <fo*C^V M,.J0^VV fc^/^ , ^^^HTW l/tJ^JH 

NameofDust Sampling Technician, Inspector, and/or Risk Assessor, if used: 

^—

Copies of renovato ^P r and dust sampling technician qualification ^^ s (training certificates, certifications) on

^

 file. 

Ii3 Copies of renovator and dust sampling techni 

0CeCertifie i d renovator provided training to workers on (check all that apply): 

IZTosting waming signs ^TSetting up plastic contaimnent barriers 

^^Maintaining containment ja^yoiding spread of dust to adjacent areas 

[^/waste handling <ZfPost-renovation cleaning 

D Test kits used by certified renovato ^atorr ttoo determin ( e whether lead was present on components affected by

renovation (identify kits used and desgrib esgribee samplin ! g locations and results:

vx^ 

y

\L\ Warmng signs posted at entrance to work area. 

\Z Work area contained to prevent spread of dust and debris. 

[ZT Widows in and within 20 feet ofthe work area are closed 

" rs in and within 20 feet ofthe work areas are closed and sealed 

Zrs that must be used in the work area are covered to allow passage but prevent spread of dust.

^oun d covered by plastic sheeting extending 10 feet from work area - plastic anchored to the 

building and weighted down by heavy objects. 

P If necessary, vertical containment installed to prevent migration of dust and debris to adjacent 

iroperty. 

Waste contained on-site and while being transported off-site. 

Renovation Recordkeeping Checklist Omaha Lead Site 
(effective April 2010) 

Work site«^operly cleaned after renovation. 

All chips and debris picked up, protective sheeting misted, folded dirty side inward, and taped for 

removal. 

(• Work area HEPA vacuumed to get paint chips from ground surface, if necessary. 

0 Certified renovator perfom^d post-renovation cleaning verification (describe results): 

z. certify under penalty of law that the above information is true and complete. 

eici\f? 

Name ancwTitle 

Renovation Recordkeeping Checklist Omaha Lead Site 
TBCHNOLOGIES, INC 

ACCESS INFORMATION TRACKING SHEET 

BVID: 	 PROPERTY ADDRESS: 


Property Owned By: 

(If new property owner) 

Owners Phone No's: Home: Work: 

Cell: - Fax: -

Access Contractor: ASW PDA MES PE Other (Prudent) 

DATE TIME ACCESSOR CONRACT DETAIL 

<^ JQb^(i^ T,)0^ M ^^AA*r--J^ 

(_p yfj ^' ' '^1 • 

•--r' 

/ ' 

Comments: 

8080 Ward Parkway, Suite 405 2505 N. 24*^ Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax:(816)363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
Checklist for the Worksite Hazard Analysis 

Address: 

Crew: Date: 0^ [ 0^(2.010. 

Item OK? Hazard Corrective Action 

Overhead Lines tE*«3 V^ A/Oi f ffbltAi. i*JL—, be AUA K 

In~transit Vehicle Clearance ^ Sov^ tAl / 

Levels around high wires 

Vehicle Clearance around 

high wires when woridng 

Phone lines 

Cable lines 

Gas Line 

Water Line 

Sewer Line 

Septic Tank 

Propane/Butane 

Access to/on Property 

Neighbor Access Required J ^ 

High Traffic Area 4 J ^ 

Garage "jVviAA M—<\ ^\ ^ tn\ b<vfcV^—al HTH (o^nr^^,, b* fkjilr. ^ ^ Structures -tJ ^ 

Driveway 

Sidewalk 

Foundation 

Retaining Walls nW^i I, ^^^ , \^.^i1<0 ^ 

Fences 

Trees 

Foliage 

General Condition of yard 

Damaged Areas: sink 

holes/rotted wood 

Sprinkler System 

Pets 

Insects 

Weather Conditions 

Unsafe driving conditions 

Unsafe neigh 

Site Safety Officer 

9. J^<^^ ^ 

808&y/ard PbrkV4iy, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas CW, MO 64114 Omaha, Nebraska 66110 San Antonio, TX 78229 

Phone: (810) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
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TECHNOLOGIBS, INC 

Prudent Property Close-Out Form (Lead-Based Paint Stabilization) 

SAID: c5^9>G\ 

Property Address: hCO S A\^m . <S'V 

Owner's Name: }Ca ^ S|I\ M 

S.NO 

Performance Standards/close-Out Criteria Yes NO 

1 

Was the entire structure(s) painted with the exception ofthe stated, 

excluded areas? This would include painting of other associated 

feature

beams,

s

 columns

 includin

,

g

 rails

 fascia

, an

, eaves

d exterio

, siding

r surface

, all trim

s of garages

, porches

. 

, box 

X

2 Was all scraping and other preparation work completed 

satisfactorily? V 

3 Were all required areas of the structure(s) primed as needed and 

painted with two top coats? V 

4 Are all ofthe areas where contaminated materials have been spilled 

thoroughly vacuumed/ cleaned? X 

5 Did the contractor collect/vacuum all falling and scraped paint chips 

o

an

n

d

 th

 als

e entir

o remov

e property

e any othe

, roadways

r generate

, alleyways

d debris? 

, public access areas 

V

6 Is the grass area that surrounds the structure(s) in reasonably good 

XL condition? 

7 Was the paint products utilized equivalent to a 30 year 

product/quality? >< ­ 8 Are all items such as polyethylene sheeting, ladders, paint brushes, 

cones, barrier tape etc properly removed? / 

9 Is there any evidence of property damage that was done by the 

contractor? Any property damage needs to be completed prior to ^ 

the EPA Close-Out. 

10 Are there any property items that were temporarily re-located by the / contractor that need to be moved back? y r 

11 Are there any (known) lingering issues with the property owner(s) >r that have been left unresolved? 

12 other Considerations? Property Owner Discussions? Additional 

Work that is Required V 

Prudent Representative Signature • ^ 

Date: ^/iXkcI O 

Property Owner Signature /M^o 

Date: Wu/J^OlO 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 308 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone:(816)363-3703 

Fax: (816) 363-3707 

Phone: (402)504-1004 

Fax: (402)504-1005 

Phone: (210)822-9588 

Fax: (210) 579-6577 
PMJDE ENVIRONMENTAL & CONSTRUCTION 

TECHNOLOGIES, INC. SERVICES 

OMAHA LEAD BASED PAINT REMEDIATION 

EPA Close-Out Form 2010 

(Lead-Based Paint Stabilization EPA Contract EP-R7-08-07) 

SAID: tlA S^ I 

Property Address: 3 <^ ^ S ' X tV,)^ |g> <^ ^ ^ 

Owner's Name: 

Performance Standards/Close-Out Criteria YES NO 

1. Was the entire structure(s) painted with the exception ofthe stated, excluded 

areas? This would include painting of other associated features including fascia, 

eaves, siding, all trim, porches, box beams, columns, rails, and exterior surfaces of 

u ^ 

garages. 

2. Was all scraping and other preparation work completed satisfactorily? u^ 

3. Were all required areas ofthe structure(s) primed as needed and painted with 

two top coats? t ^ 

4. Was the paint products utilized equivalent to a 25 year product/quality? u ^ 

5. Are all ofthe areas where contaminated materials have been spilled thoroughly 

vacuumed/ cleaned? *x' 

6. Did the contractor collect/vacuum all falling and scraped paint chips on the 

entire property, roadways, alleyways, public access areas and also remove any t ^ 

other generated debris? 

7 * ^ . Is the grass area that surrounds the structure(s) in reasonably good condition? 

8. Are all items such as polyethylene sheeting, ladders, paint brushes, cones, 

barrier tape, etc. properly removed? f ^ 

9. Isthereany evidence ofproperty damage that was done by the contractor? Any 

property damage needs to be completed prior to the EPA Close-Out. 1 ^ 

10. Has the Property Owner signed the completion form? , ^ 

11. Are there any property items that were temporarily re-located by the contractor 

that need to be moved back? w ^ 

12. Are there any (known) lingering issues with the property owner(s) that have 

y been left unresolved? 

Other Considerations/Property Ovraer Discussions/Additional Work that is Required: 

^Mh­ ^ EPA COR Signature Date 

8080 Ward Parkway, Suite 405 2505 N. 24'" Street, Suite 218 4242 Medical Drive, Suite 4250 

Kansas City, MO 64114 Omaha, Nebraska 68110 San Antonio, TX 78229 

Phone: (816) 363-3703 Phone: (402)504-1004 Phone: (210)822-9588 

Fax: (816) 363-3707 Fax: (402)504-1005 Fax: (210) 579-6577 
Douglas County Account Infonnation Page 1 of3 

Douglas County, Nebraska Property Record - R1803940000 

Print Reoort 

NEW Feature - Parcel Dimensions available (B scale 0-50 ft west of S2nd St - VlO W O n Ma O Information is valid as of 2010-3-16 Treasurer's Tax Report 

New Feature -¥ r¥ ••¥ Auto Sales Search 

Owner 

SILVA ANDRES D 

3025 NICHOLAS ST ' 

OMAHA NE 68131-0000 

Property Informatio n 

Key Number: 0394 OOOO 18 

Account Type: Residential 

Parcel Number 1803940000 

Parcel Address: 3025 NICHOLAS ST 

OMAHA NE 68131-0000 

Legal Description: MONTCLAIR ADD LOT 180 BLOCK 0 47 X 120 

Value Informatio n 

Land Improvement Total 

2009 

2008 

2007 

2006 

2005 

2004 

$2,500.00 

$2,500.00 

$2,500.00 

$2,500.00 

$2,500.00 

$2,500.00 

$72,600.00 

$72,600.00 

$72,600.00 

$72,600.00 

$72,600.00 

$43,900.00 

$75,100.00 

$75,100.00 

$75,100.00 

$75,100.00 

$75,100.00 

$46,400.00 

Sales Informatio n 

Sales Date: 2009-09-14 

Deed Type: WD BooAr: 2009 Page: 113395 

Price: $90,000.00 

Grantor: FENNELL MADALINE L 

Grantee: SILVA ANDRES D ETAL 

Vaiid/lnvaiid: Valid 

Exclusion Reason: 

Sales Date: 1995-12-23 

Deed Type: D Book: 2026 Page: 523 

Price: $41,000.00 

Grantor: 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R1803940000 3/23/2010 
Douglas County Account Information Page 2 of3 

Grantee: 

Valid/Invalid: Valid 

Exclusion Reason: 

Land Informatio n 

Acres SF Units Depth Width Vacant 

0.12 5640.0 1.0 120.0 47.0 No 

Improvemen t Informatio n 

Building 1 

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likiLiK,i,iM.»iimiAwiia»AH.4«!m» # B 1iM 

1 CLICK TO ENLARGE IMAGE | CLICK TO ENLARGE IMAGE 

Square Footage: 1712.0 Percent Complete: 100.0% 

Perimeter 0.0 Quality: Average 

Unit Type: Condition: Average 

Built As: 2 Story Condo Square Footage: 0.0 

HVAC: Central Air to Air Rooms: 8.0 

Exterior: Frame Siding Units: 1.0 

Interior: Drywall Baths: 1.0 

Roof Cover: Composition Siiingle Bedrooms: 3.0 

Roof Type: Hip Stories: 2.0 

Floorcover: Allowance Foundation: Block 

Sprinitler Square Footage: 0.0 

Year Percent Adjusted Year Year Built Physical Age Remodeled Remodeled Built 

1920 0% 1920 90 

DetaiY Type Detail Description Units 

Appliance Allowance 1.0 

Basement Bsmnt Block 8 ft 840.0 

Fixture Base Fixtures 1.0 

Fixture Bath Full 1.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=Rl 803940000 3/23/2010 
Douglas County Account Infonnatton Page 3 of3 

Garage Detached 252.0 

Porch Cvrd Wood Deck 166.0 

Porch Wood Deck 28.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R1803940000 3/23/2010