# Transmitta l o f

Omah aLea dSite Pain t Stabilizatio n Fil e Folde r
Sai d#3 5 2 6^ 0 Date : 7f-^l-) / Address : "V/^ i C>^^^-f^ U Contractor : CityofOmah aYear : &- b t 7 

# Pain t Stabilizatio n Propert y Fil e Folde r Document s tXwor k Writ e U P Z-^ P 

### Signe dAcces s Agreemen t fo r

subject propert y , Pre-Renovation for msigne dby Propert y Owne r Pre-Renovation For mfo r

Occupant/Tenant,.if applicable Painting Agreeinent/Cit y o f

Omah aPurchas e Orde r Settlemen t documents (i.e. , fo r

damag e o r

t

o replac e plants , etc. ) Renovatio n Recordkeepin g Checklis t signe dby Certifie dRenovato r
^ Propert y informatio n fromDougla s Count y Assessor' s Offic e Othe r

(describe) : XuOfV^i. S •. .

CityofOmah aRepresentativ e Signatur e Dat e

EP A Representative Signatur e / /Dat e 3026250 9 

# llll l Superfun d

# CIT Y O F OMAH A PURCHASIN G - ROO M 100 3 

### Purchas e Orde r

181 9 FARNA M STREE T PAG E REVISIO N OMAHA
. N E 68183-100 3 117440 2 • PURCHAS E ORDE R NO
. 0 FAX1 » 402-444-542 3
SHIPTO : CIT Y O F OMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T OMAHA,N E 6816 3 M S SERVICE S IN C • < VENDOR : > 894 3 J S T BIL L TO : CIT Y O F OMAH A FINANC E OMAHA , N E 6812 7 DISBURSEMENT S ROO M #100 7 181 9 FARNA M STREE T OMAHA.N E 6818 3 ORIGINA L PURCHAS E ORDE R • VENDOR' S COP Y (SE E INSTRUCTION S BELOW ) /^CUSTOME R ACCOUN T NO
. I VENDORNO
. DAT E O F ORDER/BUYE R REVISE D DATE//BUYE R 9266 5 11-MAY-1 1 HHUR T PAYMENTTERM S SHIPVI A F.O.B
. DESTINATIO N FREIGHTTERM S REQUEST0RA3ELIVE R T O CONFIR M T O / TELEPHON E MARTINEZ , MARGARE T P > < ITE M PAR T NUMBE R / DESCRIPTIO N DELIVERYDAT E QUANTIT Y UNI T UNITPRIC E EXTENSIO N Al l price s an d amount s o n thi s orde r ar e expres s ; d ir i ; U S Dol : a r NEEDED : 3,675.0 0 N 12-MAY/-1 1 EP APAINT STABILIZATION PROGRA M GR P #19 8 - 410 3 GRAND AV E i O SHI P TO : Addres s a t to p o f pag e

SHI P TO : Addres s show n atx>ve
. I f shipmen t I s delaye d o ran y Item s not available , advis e at once . Pur ^ chas e orde rnumbe rmus t appea ro n al l Invoices , packages i packin g lists , bil l of lading , an d correspondence
. 

### Tota l ( 3-«7 5 0 ° ) SHIPPIN G CHARGE S T O B E PREPAID
. I F APPLICABL E AN D ADDE D T O INVOICED , cop y t o b e fur ­ nishe d Witt ) Invoice
. TAX EXEMPTION : Th e City o f Omah a 1 3 exemp t from Federa l Excis e Taxe s an d th e Nebrask a an d City o f Omah a Sale s Taxes
. Federa l I.O
. 476006304 ; STAT E I.D
. 01-0316768 : Fue l Dealer s Lie
. 91-0316768
. l y PurehKln g Agj(il | Buy wPlannin g Departmen t Omiha,/Dou.g!a s Civic Onic t Inspector : Chri s Grummon s 181 9 Fir-na mStreet , Suit e MO O Dat

- 4/7/1 1 Om-iha , Ncbrss b 6313 3 (402)444-515 0 Tcicfi x (402 ) 444-614 0 

## Name : LaRo n Gree n R
. E
. Gunnaxigham , RA , F.SAM E Ge y o f Oinah a DirtCto r Ji mSutde , Mayo r 

## Address : 410 3 Gran dAv e OMAH A EXTERIO RPAIN T STABILIZATIO N PROGRA M FO RTH E EP A OMAH A LEAD SIT E Th e Contrac t biddocument s consis t ofth e following sections : •Genera l Responsibilitie s fo r th e Contracto r atidOccupant
. • Lead
. Hazar dControl-Plan , InterimContro l of Lea d Ba-se dPain t Hazards
. 

## Th e Contracto r Shall ; •CJontracto r an dal l subcontractorfs ) shal l complet e andsubmi t a"Citizenshi p Attestation " / "Emplf>vee Clasjification " for mt o th e Plannin g Department , pe r Stat e requirements , befor e final paymen t ean b e issued
. • . Comply wit h HUD' s "Guidelines'for.th e Evaluatio n an dContro l o f Lead-BasedPain t

- Hazard s i n Housing. " (Copie s ar e ayallablsa t th e Planning Department. ) •Comply wit h Standard s calle dfo r i

n th e "Constructio n an dRehabilitatio n Specifications , Housin g an dCommunit y Deyelcpmen t Division , Cit y o f Oniaha , Nebraska. " (Copie s ar e availabl e a t the-Plannin g Department.)

- ' •»

. Comply \yit h th e State ofNebrask aHealt h an dHumai i Service s Regulatio n an d Licensure,-Titl e 17 8 Chapter 2 3 Lea dBas e Paint Regulations
. • • . » Coordinatedail y construction'schedul e wit h th e occupan t
.- . ; • • , Subnii t informatio n ciit.sheet. s fo r al l substitution s p r approve dequal s pirio r t

o writte n \• ' approva l ofth e Ccinstmctio n Specialist
. •...;. :
• '.Repair o

r replac e all item' s damage dO r disturbedduring.pain t stabilizatio n activities. '
• Keep wor k

site andsurroundin g are afre e fro maccumulation s o f wast e material s o r

, • rubbishcause dbythe.work atall.times
. « Upondail y completio n o f work : clea n u p all rubbish , exces s material , equipment , an d• etc.j.tha t i s cotinecte dwjt h th e work,an dleav e all.part s ofth e vyork ' area s i n aneat , sanitary , lea dsaf e andpre.sentable condition
. • Complete thi s projec t withi n 3 0 calenda r days
. Th e Occiipant/Gwiie r iShall- ' • Remov e tind
. -Stor e awa y aii y persona l propert y within Iwcn'c y (20 ) fee t of th e areat o -b e rerncdiaied
. •'-..•---•-

­ •Provid e acces s t o electricit y andwate r throughou t th e pain t stabilizatio n proces.s . •Remove , voluntee r treesan dvegetatio n fro mth e dri p lin e o f th e roof , .<in dcu t bac k shrub s an dbushe s a t leas t tw o fee t fron i th e house
. «' Ensurethatal i househol dmember s sta y a t leas t te

n feetawa y fro mal l wor k

area s an d als o keep al l pet s a t leas t ten fee t awa y a t all time s until th e wor k

ha s bee n completedan d th e are aha s passe davisua l inspection
. I / ^ Initial s u.Ls >

### Exterio r Lead-base dPain t Stabilizatio n Progra mVlanage db y th e Cit y o f Omah afo r EP A Regio n 7 Omah aLea dSit e Th e purpos e o f thi s progra mi s topreven t yard s where lead-contaminate dsoi l i s cleane d u

p from-becomin g re-contaminate db y deterioratin g exterio r lead-base dpaint
. Thi s i s no t ahom e repai r program . Whic h Home s Ar e Eligible ? •Home s wher e soi l clean-up ha s been o r wil l b e done an da n EP A contractor has ' identifie ddeterioratin g exterio r lead-base dpaint
. •Home s ar e eligibl e only b y referra l fro mth e EPA
. Wha t wor k

wil l b e done ? •Loos e an dflakin g lead-base dpaint will b e remove dsafel y fro mfascia , eaves , siding , trim , windo w trim , doo r triman dfoundation
. •'Surface s wil l b e prime dan dpainte dt o matc h existin g paint color a s closel y a s possible
. • ' • . Wha t wil l no t b e done ?

. • Surface s whic h hav e n o paint wil l no t b e treated
.

. • ' Window s o r doorswil l no t b e included
.

­ . • Rotte n woo dwil l no t be'replaced
. •N o housin g repair wil l b e done
. Wh o wil l perfor mth e work ? •EP A contractor s will tes t paint o n exterio r hous e surface s an dgive-th e result s t o th e Cit y o f Omah aPaint .Stabilizatio n Program
. •Cit y Constructio n Specialist s wil l prepar e a ' wor k

pla n an dcontac t the'propert y

. owne r fo r permissio n to proceed
. • .Wor k

wil l b e competitively bi dby approved , traine dcontj-actors , When wil l th e wor k

b e done ? •Thi s progra mbegan i n 200 7 an dwill , continu e fo r severa l years . •Th e Cit y staf f wil l prioritiz e home s base don th e presenc e o f childre n under ag e si x i f know n an dth e severit y of th e problem
. Paint Stabilizatio n i s voluntai y an dwil l b e don e onl y wit h permission of the owner. ' Initial s U ^

### Address : 410 3 GR.AND.A. V Consent fo r Acces s to Propert v fPage 2 ) 3.
. Plannin g an dimplementin g th e respons e actio n on.th e Grantor' s property.'Thi s wil l include 1 ) remova l o f loos e o r flaking paint identifie db y EP.A
. iising lead-saf e method s i n complianc e • • wit h HUD/EP. A regulation s an d2 ) repaintin g accordin g to th e attache dspecifications
. TER M Thi s acces s agreement shal l b e operabl e fo r the perio dof-tim e i t take s t o complet e th e enviromnental respons e activities. ' Upon completio n o f the respons e actions , al l right s an d privilege s give n b y th e Grantor shal l ceas e o n tha t date , unles s extende db y asubsequen t agreement . AGREEMENT NOTT O INTERFER E Graij-to r agree s not t o interfer e wit h any.o f th e activitie s undertake n b y Grante e a t th e Property , ' tamper withan y o f Grantee' s property,o r tak e an y actions , regarding th e us e ofth e Propert y whic h wil l endanger huma n healt h o r welfar e o r th e environment , o r allow other s to lis e the Propert y i n suc h manne r durin g th e ter mo f thi s consent . Grantor agree s t o provid e notic e an dacop y o f this agreement to prospectiv e purchasers , lessees , assigns , or grantee s of the propert y o r an y portio n o f it
. Granto r agree s to provide 30-da y notic e t o EP A prior t o an y transfe r o f ownershi p right s t o th e property . SAMPLIN G RESULT S Grante e agree s to provid e Grantor wit h the results , o f an y an dal l sampling and/or analysi s resultin g fro mGrantee' s respons e activitie s o n theproperty
. PRIO RCONDITION S AGREEMENT ' Th e granto r agree s t o th e conditio n ofth e propert y prior to remediation an dindicate s o n Pag e 3 an y item s t o b e remove dby the Grantor befor e activitie s commence . RESTORATIO N OF PROPERT Y Excep t fo r th e abov e statedpaint stabilization , th e Grante e agree s tha t sai dpropert y wil l b e restored a s nearl y a s possibl e t o it s origina l state andconditio n a s foun dimmediatel y precedin g th e beginnin g of activitie s authorize db y thi s Agreement , followin g completio n o f th e respons e activities
.

### Dougla s Count y Accoun t Infomiatio n Pag e 1 of 4
pougla s County , Nebrask a Propert y Recor d - R130286000 0 Prin t Repor t View
. Interactiv e GI S Ma p Informatio n i s vali d a s o f 2012-2-2 8 Treasurer' s Ta x Repor t Ne w Featur e - • - > ^ Subdivisio n Sale s Searc h Owne r GREE N LERO N D ETA L 410 3 GRAN D AV E OMAHA.N E 68111-000 0 Propert y Informatio n Ke y Number : 028 6 000 0 1 3 Accoun t Type : Residentia l Parce l Number : 130286000 0 Parce l Address : 410 3 GRAN D A V OMAHAN E 68111-000 0 Lega l Description : HASTING S & HEYDEN S SU B DI V LO T 1 BLOC K0 4 0 X 12 5 Valu e Informatio n Lan d Improvemen t Tota l 201 1 201 0 200 9 200 8 200 7 200 6 $4,300.0 0 $4,300.0 0 $4,300.0 0 $4,300.0 0 $4,300.0 0 $4,300.0 0 $73,700.0 0 $81,000.0 0 $65,300.0 0 $65,300.0 0 $65,300.0 0 $65,300.0 0 $78,000.0 0 $85,300.0 0 $69,600.0 0 $69,600.0 0 $69,600.0 0 $69,600.0 0 Sale s Informatio n SalesDate : 2004-03-2 5 Dee d Type : W D Book : 200 4 Page : 05625 7 Price : $ 82,875.0 0 Grantor : BE N UVMPMA N ETA L Grantee : LERO N D GREE N ETA L Valid/invalid : Vali d Exclusio n Reason : Sale s Date : 2001-03-3 0 Dee d Type : W D Book : 217 7 Page : 8 3 Price : $ 50,000.0 0 Grantor : 

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### Dougla s County Accoun t Informatio n Pag e 2 of4
Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sate s Date : 1996-03-2 4 Dee d Type : D Book : 203 3 Page : 38 0 Price : $51,500.0 0 Grantor : Grantee : Valld/lnvalld : Vali d Exclusio n Reason : Sho w Al l Transaction s

Lan d Informatio n Acre s S F Unit a Dept h Widt h Vacan t 0.1 1 5000. 0 1. 0 125. 0 40. 0 N o Improvemen t Informatio n Buildin g 1
1 1/ 2 FI N

—— J I
— —

CLIC KT O ENLARG E IMAG E Squar e Footage : 1690. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : Condition : Averag e

Buil t As : 1 1/ 2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 9. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo f Type : Gabl e Stories : 1. 5 Floorcover : Allowanc e Foundation : Bloc k


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### Dougla s Count y Accoun t Information Pag e 3 of 4
Sprinkle rSquar e Footage : 0. 0 Yea rBuil t 191 6 Detai l Typ e Ad d O n Applianc e Basemen t Fixtur e Fixtur e Garag e Porc h Porc h yea r Remodele d 0 Percen f Remodele d 0 % Detai l Descriptio n Fenc e Woo d Allowanc e Bsmn t Bloc k 8 f l Bas e Fixture s Bat h Ful l Detache d Sla b Roo f Ceilin g Woo d Dec k Adjuste d Yea r Physica l Ag e Buil t 191 6 9 6 Unlt a 1. 0 1. 0 720. 0 1. 0 1. 0 336. 0 224. 0 100. 0



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### Dougla s Count y Accoun t Infonnatio n Pag e 4 of 4

Th e abov e rna p i s powere d by Google , an d i s intende d t o provid e a genera l ide a o f a property' s location
. I f yo u requir e a mor e exac t propert y location , yo u ma y us e th e Interactiv e GI S Map s tha t ar e maintaine d by ou r office
.



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R l 3..
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