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HomeMy WebLinkAbout1995 01-23 EDAP Regular Session CITY COUNCIL AGENDA -4- January 23, 1995 EDA AGENDA CITY OF BROOKLYN CENTER JANUARY 23, 1995 (following adjournment of City Council meeting) 1. Call to Order " r. 2. Roll Call I I u 3. Approval of Agenda and Consent Agenda i -All items listed with an asterisk are considered to° be routine by the Economic Development Authority and will be enacted by one motion. There will be no separate discussion of these items unless a Commissioner so requests, in which event the item will be removed from the consent agenda and considered at the end of Commission Consideration Items. a. Approval of Minutes: January 9, 1995 - Regular Session - Commissioners not present at meetings will be recorded as abstaining from the vote on the minutes. 4. Commission Consideration Items a. Resolution Approving One (1) Brooklyn Center Economic Development y Authority Deferred Loan (File No. H -128 [8054]) b. Resolution Approving One (1) Brooklyn Center Economic Development Authority Deferred Loan (File No. H -129 [8055]) y o A i i , r � t 5. Adjournment J i Council Mewing Date Janney 23, 1995 � of Bro Center ener 3 �'�'J � B ,y Agenda Item Number Description: Item Descri P Request For Council Consideration • EDA Minutes - January 9, 1995 - Regular Session Department Appro 1 7 &,, e < G. Brad U LLuffman, Director of Community Development Manager's Review /Recommendation: J No comments to supplement this report Comments below /attached Recommended City Council Action: • Summary Explanation: (supporting documentation attached Yes ) January 9, 1995 - Regular Session All Commissioners were present. MINUTES OF THE PROCEEDINGS OF THE ECONOMIC DEVELOPMENT • AUTHORITY OF THE CITY OF BROOKLYN CENTER IN THE COUNTY OF HENNEPIN AND THE STATE OF MINNESOTA REGULAR SESSION JANUARY 9, 1995 CITY HALL CALL TO ORDER The Brooklyn Center Economic Development Authority (FDA) met in regular session and was called to order by President Myrna Kragness at 8:24 p.m. ROLL CALL President Myrna Kragness, Commissioners Barb Kalligher, Kristen Diann, Debra Hilstrom, and Kathleen Carmody. Also present were City Manager Gerald Splinter, Director of Community Development Brad Hoffman, Director of Public Services Diane Spector, Finance Director Charlie Hansen, City Attorney Charlie LeFevere, and Council Secretary Barbara Coalman. i APPROVAL OF AGENDA A D CONSEN kGFMA President Kragness inquired if any Commissioner requested any items be removed from the consent abcnda. No requests were made. There was a motion by Commissioner Kalligher and seconded by Commissioner Mann to approve the agenda and consent agenda as prinked. The motion passed unanimously. APPROVAL OF MINAS DECEMBER 19, 1994 - REGULAR SESSION There was a motion by Commissioner Kalligher and seconded by Commissioner Mann to approve the minutes of the December 19, 1994, EDA meeting as printed. The motion passed unanimously. 19/95 1 - RESO UT� IONS RESOLUTION NO. 95-01 i ing resolution and moved its adoption: Commissioner Barb Kalligher introduced the follow RESOLUTION DESIGNATING DEPOSITOR OF FDA FUNDS The motion for the adoption of the foregoing resolution was duly seconded by Commissioner Kristen Mann, and the motion passed unanimously. RESOLUTION NO 5-02 Commissioner Barb Kalligher introduced the following resolution and moved its adoption: RESOLUTION ACCEPTLNG QUOTE AND .AUTHORIZING THE PURCHASE OF CARPET FOR CAPTAIN'S, ESTATE, AND COAT ROOM The motion for the adoption of the foregoing resolution was duly seconded by Commissioner Kristen Mann, and the motion Passed unanimously. ADJOURNMENT Thurw was a motion by Commissioner Mann and seconded by Commissioner Kalligher to adjourn the meeting. The motion passed unarimously. The Brooklyn Center Economic i adjourned at 8:25 . .m nt Auth ority P L�evelo me Au p ty J President Recorded and transcribed by: Barbara Collman TimeSaver Off Site Sccretarial 1 ll 9 95 • Council Meeting Date 1 -23 -95 City of Brooklyn Center Agenda Item Numbe Request For Council Consideration Item Description: RESOLUTION APPROVING ONE (1) BROOKLYN CENTER ECONOMIC DEVELOPMENT AUTHORITY GRANT (FILE NO. H -128 [8054]) Department Approval: Thomas Bublitz, Community Develop nt Sped � 0 st Manager's Review /Recommendation: No comments to supplement this report Comments below /attached • Recommended City Council Action: Staff recommends motion to adopt Resolution approving one (1) Brooklyn Center Economic Development Authority Grant (File No. H -128 [8054]) Summary Explanation: (supporting documentation attached ) This information is private and not available to the general public. This resolution would approve one (1) application for a rehabilitation deferred loan (File No. H -128 [8054]). Attached is the application and recommendation for work to be performed on the home. The applicant filed the initial application for deferred loan program on May 17, 1993 which is the date that established the applicant's position on the deferred loan program waiting list. It should be noted this applicant has been moved ahead of the applicants on the waiting list due to the severity of the roof leaks in the house. If the leaks are not repaired significant water damage could occur in the house. The application dated December 9, 1994 is the date of the applicant's formal income verification application which is completed by Hennepin County staff once the application reaches the top of the waiting list. The home /applicant has not received a previous grant under the program. ® H -128 [8054] Page 2 The 1994 market value for File No. H -128 [8054] property is $81,200 and the exterior of the home does not meet the EDA's exterior maintenance requirements and will require repairs to soffit and fascia. Installation of central air is included to the work specifications. Air conditioning is allowed under the program in specific instances where it is considered a medical necessity and requiring a letter from a physician specifying the need. A copy of the letter is included in the Council's packets. With this deferred loan project and the other project on the agenda, staff is using a new form for the project work specificiations. We believe this form will be easier to use for homeowners and contractors and will also be very specific in terms of the required work. Our current work specifications (copy enclosed) have served the program well but some contractors find it difficult to work with and we believe the new forms are an improvement. • i MEMORANDUM • TO: Tom Bublitz Community Development Specialist Y P P� FROM: David Fisher, Building Inspector DATE: January 3, 1995 SUBJECT: Rehabilitation grant for 6031 Halifax Avenue North Owner: Josephine Chamberlain H -128 (8054) The subject property is a 4 bedroom rambler built in 1955. The exterior is stucco in good condition, but the roof, soffit and facia needs some work. The yard is maintained. The City Assessor has valued this property at $81,200. The following is a list of repairs that will help bring this dwelling up to code. • URBAN HENNEPIN COUNTY HOUSING REHABILITATION PROGRAMS CONTRACTOR BIDDING INSTRUCTIONS THE CONTRACTOR SHALL SUBMIT A CONSTRUCTION BID PROPOSAL THAT COMPLIES WITH THE FOLLOWING CONDITIONS. REFER TO BASIC GENERAL SPECIFICATIONS AND WORK CONTRACT FOR FURTHER CONTRACTUAL INFORMATION. Bid - The Construction Bid shall entail a write -up of complete specifications for the proposed rehabilitation work. Write-up hall specify brand names materials P P Y , dimensions, itemized cost, finishing and include all labor, equipment, and services required for proper completion of the work. Scooe of Improvements and Work Proposal - The contractor is requested to use the prepared Scope of Improvements and Work Proposal form as the contracting bid when bidding the rehabilitation work. A contractor's bid written up on a different form will be accepted only when the bid is complete with detailed work specifications and includes the individual cost per item. However, the Scope of Improvements shall take precedence over other specifications and when in conflict, the material, equipment, or workmanship, as called for in the Scope Improvements will be required. Requested drawings are for clarification /illustration purposes. Materials - Installed materials shall be new, of medium quality and grade. Owner shall • select colors or patterns furnished by the contractor from readily available supplier's selection. If a cost allowance is specified, and the color or pattern selected is more than the allowance, the owner shall pay the cost difference. Workmanship shall be in accordance with trade standards. Installation and /or application shall be in compliance with the manufacturer's specifications and /or comply with applicable codes and their requirements. All operational manuals for new installed equipment shall be provided to the owner. Existing Systems - When the Scope of Improvements specifies plumbing, electrical or mechanical work, involving the existing system, the contractor shall submit a bid for the code work which has not been listed in the Scope of Improvements and which would be required in order for that entire system to comply with the minimum housing standards and /or code requirements. Alternatives - The contractor may submit an alternative bid that is written up on a separate form titled "Alternatives ", when an item is not listed and /or when the contractor feels that there is a better method for the corrective work than what has been proposed in the Scope of Improvements. The alternative bid does not relieve the contractor from bidding the item as written up in the Scope of Improvements. Re ulations and Licenses - It is the responsibility of the contractor to execute proper P Y P P regulation procedures and to obtain all licenses and permits as required by governing • agencies (MN Occupational Safety and Health Administration, MN Pollution Control Agency, MN Dept. of Health, etc.) when working with materials that may cause possible health and environment - related risks, such as, but not limited to, asbestos. and lead. i� URBAN HENNEPIN COUNTY HOUSING REHABILITATION PROGRAMS CONTRACTOR BIDDING INSTRUCTIONS (CONTINUED) • Lead Paint - Exterior and interior paints, enamels and primers used on any surface in structures constructed or rehabilitated through the Urban Hennepin County Housing Rehabilitation Programs will no contain more than six one - hundredths of one per centum lead by weight (calculated as lead metal) in the total nonvolatile content of the paint or the equivalent measure of lead in the dried film of paint already applied. Codes - The contractor shall give all notices required by and comply with all applicable building codes and regulations of the local building inspection department including the obtaining of and payment for any required permits; provided that the contractor shall not be held responsible for pre - existing violations. Except any and all new replaced work included in the contract will be required to comply with such codes or regulations. Before beginning the work, the contractor shall examine the Scope of Improvements for compliance with the applicable codes and regulations for the new or replaced work and shall immediately report any discrepancy to the owner or program administrator. Damage to Property - When adjacent property is affected or endangered by work done under contract, it shall be the responsibility of the contractor to take whatever steps are necessary for the protection of the adjacent property and to notify the owner there of such hazards. Surplus Materials - all surplus materials delivered to the job site and all materials, • fixtures and equipment removed and not reused shall remain or become the property of the contractor and the subcontractors and shall be removed from the job site promptly after completion of the work, as well as all rubbish and debris resulting from the contractor's operations. The premises shall be left in broom -clean condition. Site Condition - The contractor shall be held to have visited the site and checked with the owner about the working conditions and the methods of carrying out the work. The owner shall permit the contractor to use, at no cost, existing utilities, such as light, heat, power, and water, necessary to carry out the completion of the work. General Contractor - The contractor shall be responsible for the fitting of all work and for the coordination of the operations of all trades, subcontractors or material persons as required for proper completion of the rehabilitation work. Bid Rejection - Bids or proposals will be submitted at the bidder's risk. The owner and /or administrating entity reserves the right to reject and or all bids or proposals. page 2 of 2 • SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: CDBG Deferred Loan Program PROPERTY: 6031 Halifax Avenue North ELECTRICAL - Furnish materials, accessories, fittings and equipment and perform work as required to place the electrical system in a complete, proper and legal operating condition. Upon completion, the electrical work in the dwelling shall be in compliance with the requirements of the FHA minimum standards, NEC and State codes. $ 1. Wire 100 AMP service. Replace existing main service panel with 100 AMP circuit breaker, 20 pole with main breaker, UL listed. Tie in all circuits. Replace entrance cable with proper size wiring and rigid conduit. Ground service. Locate meter to exterior of dwelling. $ 2. Install grounded receptacle for water softener. $ 3. Install "GFI" wall receptacle in both bathrooms. $ 4. Install "U.L." listed hard wired smoke detector per manufacturer's instructions. • $ 5. Provide separate 15 "AMP" circuit to furnace. $ 6. Remove hanging receptacles in basement. $ 7. Provide jumper wire over water meter per code. $ 8. Wire garbage disposal properly. $ 9. Relocate electrical mast to code. • SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: CDBG Deferred Loan Program PROPERTY: 6031 Halifax Avenue North MECHANICAL $ 1. Install new furnace. Remove existing unit and haul away debris. Install a new forced -air heating unit, AGA or UL listed, Carrier or equal, that will maintain a safe and adequate heat supply to each conditioned room in the dwelling unit. The installed unit shall be designed to meet or exceed 80% annual fuel utilization efficiency. Installation shall include combustion air intake and new thermostat. New unit shall be vented to an approved flue. Bid shall specify condition of existing flue, if flue needs replacement, and cost of replacement if necessary. Reconnect to plenum. Wire on separate circuit. Installation shall be in compliance with manufacturer's specifications and local building code requirements. Bid shall specify the brand name, BTU /size and AFUE of installed heating unit. $ 2. Install new central air conditioning unit, UL listed, Carrier or • approved equal, minimum SEER 10.0 and for complete assembly. Wire on a separate circuit. Connect to existing furnace ductwork. Properly size unit for area. Specify brand and size: • SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: CDB Deferred G Program PROPERTY: 6031 Halifax Avenue North PLUMBING - All work performed shall be in compliance with the State and local applicable plumbing code requirements. The system shall be in a health -safe and proper worker order. Contractor shall be responsible for obtaining all necessary permits prior to starting work. $ 1. Install a new gas shut -off valve gas dryer. AGA listed; ball type with lever handle. Locate within 3' -0" of range. Must be readily accessible. $ 2. Install water softener. Properly sized and conditioned and connected to water supply lines with by -pass valve. Wire an accessible electrical outlet as needed (extension cords are not permitted). Owner will be responsible for supplying the salt. Specify brand name, size and warranty: $ 3. Install a new water closet 17 " -20" in height from the floor • to the finished seat height; white, vitreous china with closed couple tank, anti- siphon ballcock and seat with cover. Kohler Highcliff or equal. $ 4. Abandon existing well per State and local codes. Repair, to code, an damage done to structure caused b removal. Y � Y Provide reasonable protection to lawn, driveways, and neighboring areas. $ 5. Repair or replace all leaky waste pipes. $ 9. Code plumbing system. Specify all other plumbing code work not listed above and the cost per work item. SCOPE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program • PROPERTY: 6031 Halifax Avenue North MISCELLANEOUS $ 1. Repair walls to sound condition in the following areas. Living room ceiling, main bathroom ceiling, and basement ceiling. Remove all loose, chipping, flaking, peeling plaster /browncoat; patch with Durock or equal; apply finish coat; sand smooth and blend to surrounding plaster; prime for paint. $ 2. Remove old and loose grout and caulk around bathtub and replace with new. $ 3. Install new resilient floor covering in bedroom bathroom. Remove existing covering, unless contractor specifies otherwise. Clean and repair surface. Install 1 /4" structural grade plywood and new sheet vinyl floor covering; Armstrong, Sundial or equal. Owner's choice of color and pattern. $25.00 sq yd, installed, allowance. Edging of floor covering shall be covered (discuss and confirm material and finish with owner). $ 4. Secure all loose carpet at entries into bedrooms. $ 5. Install grab bars: TOILET: install grab bars with outside diameter of 1-1/4" and 1-1/2" clearance from walls and partitions on both sides or one side and one rear of the toilet ( the side a horizontal bar 10 above the seat, projecting 6" in front of the seat, and a vertical bar 12" in front of the seat, mounted 12" above the seat and extending to 30" above the seat; at the rear a horizontal bar at the greater of 2" above the tank, or 10" above the seat). SHOWER: install grab bars with outside diameter of 1-1/4" and 1-1/2" clearance from walls on two sides of shower ( a vertical bar on the wall opposite the seat, installed at 3' -0" above the floor and extending to 5' -0" above the floor, and a horizontal bar adjacent to the seat, installed at 10" above the seat and a minimum of 18" long). No diagonal wall mounted bar installation is permitted and obstruction clearance shall be a minimum of 9" from corners. Contractor will discuss positioning and • SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: OG CDBG Deferred Loan Program PROPERTY: 6031 Halifax Avenue North MISCELLANEOUS CONT. design of grab bars with owner prior to installation. Grab bars shall be stainless steel and secure to wall framing. $ 6. Install new labeled steel insulated fire door, 1 -3/4" minimum thickness, flush, prehung unit with or without window. Castlegate or equal. Install new hardware, threshold, weatherstripping and lockset. Key alike to other doors and supply owner with 2 keys. Reuse casing and trim. Option: Apply painter's finish of owner's choice $ $ 7. Repair front storm /screen door. $ 8. Replace 2 missing basement storm /screen combination windows, aluminum frame, 2 -track and self- storing screen and storm inserts for complete assembly, Benada or equal. • Owner's choice of color. $ 9. Install new storm /screen combination windows, aluminum frame, 2 -track and self- storing screen and storm inserts for complete assembly, Benada or equal. Onwer's choice of color. Replace all storm windows - kitchen 3, dinning room 2, living room 2, main bathroom 1, bedroom bathroom 1, right bedroom 2, middle bedroom 2, middle bedroom 3, and left bedroom 2. (18 total storm windows) $ 10. Insulated attic space to R -44 rating. Air chute shall be installed where there is soffit venting. Provide protection around all recessed lights, junction boxes and chimney. $ 11. Insulate rim joist with fiberglass batts, friction fit, R -21. Seal cracks and voids. $ 12. Tear off existing layers of roofing down to bare wood. Haul away all debris. Prepare surface for new roofing. Surface shall be even, sound, thoroughly clean,, dry and free from all defects that might affect the quality of application. Flashing, plumbing jacs and roof vents shall be checked and replaced with new when damaged, defective, SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: CDBG Deferred Loan Program PROPERTY: 6031 Halifax Avenue North MISCELLANEOUS CONT. rusted or missing. Roof venting shall meet State and local building codes; install as necessary to meet code. Install metal drip edge along roof edge where gutters and ribbon boards are not installed. Reline valleys with new W- formed flashing. Install ice and water shield /starter along eave and extend a minimum of 24" inside the exterior wall. Install new UL listed 240# 3 -tab fiberglass strip shingles using 4 nails or staples per shingle, laid over one layer non- perforated Type 15 felt. Ridge shall be individual shingles laid "Boston" style. New shingles shall be GAF, Certainteed or equal. Owner's choice of colors. Installation shall meet State and local building codes and /or manufacturer's specifications (whichever is most restrictive). *Replace all rotten or damaged roof sheathing /boards with new. Specify separate /added cost for board replacement $ e per sq foot. $ 13. Cover entire trim area around windows and doors with .019 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Materials shall be lapped for proper drainage. House and garage. Owner's choice of color. S 14. Cover entire soffit area with .019 baked enamel prefinished aluminum, Alcoa or equal. Replace rotten and damaged boards. Materials shall be lapped for proper drainage. Apply aerated material to vented soffit area and ensure soffit venting that is open to attic area for unobstructed air flow. Owner's choice of color. $ 15 Cover entire facia area with .019 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Materials shall be lapped for proper drainage. House and garage. Owner's choice of color. • SCOPE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program PROPERTY: 6031 Halifax Avenue North MISCELLANEOUS CONT. $ 16. Install new gutters and downspouts, baked enamel prefinished aluminum, Alcoa or equal. Gutters shall be 5" seamless, secured to the roof edge 36" or less on center and pitched to facilitate drainage. Downspouts shall be 2" x 3" corrugated, secured to wall and with an installed extension, extending a minimum of 6' -0" out from downspout. Owner's choice of color, Install new at same location as removed and for complete assembly. Dispose of old, removed gutters and debris. Straps shall not be installed on top of shingles. Examine, clean, and repair /replace if necessary, any adjoining work on which the gutters and downspouts are in anyway dependent for proper installation. $ 17. Replace kitchen cabinet top: Kitchen counter top - shall be self edge or self forming formica with 4 inch backplash. • Separate backsplash material shall match formica counter top material. S 18. Regrade along foundation walls. Owner will be responsible for salvaging plants. Prepare area. Bring in fill free of debris and compact to proper density (avoid damaging lot settlement ). Fill shall be impermeable composition. Install new fertile, black soil, to a minimum depth of 4 ". Place and rake over a well compacted sub - grade /fill. Finish grade line shall 4 - me s a have a slope of 1 /4 -1 /2 per foot out 0 to 6 - 0" from wall or as clearance permits to direct drainage away from house. Top of area well shall be adjusted to extend 3" above grade. Areawell shall be filled with 1' -0" drainage rockfill and shall extend not less than 1" below window sill. Owner shall be responsible for seeding or sodding topsoil /backfill. Option contractor may submit a bid for sodding new backfili area. New sod shall be free of weeds, Bluegrass /equal and blend in with adjoining work. Roll and compact to assure proper bond with soil. If sod fails in the first month, the contractor will be responsible for • replacing sod at no extra cost $ SCOPE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program ogra m PROPERTY: 6031 Halifax Avenue North MISCELLANEOUS CONT. S 19. Trim trees around house and garage. Haul away debris. Owner will be responsible for seeding or sodding area. $ 20. Repair or replace front sidewalk to front steps. Break up and remove existing sidewalk. Form new concrete sidewalk on 4" compacted sand or equal fill. Concrete shall be a minimum 4" thick and sloped for proper water flow, approximately 1/8" per foot. Install proper joints. Screed concrete to proper grade /elevation and broom finish. Place new concrete sidewalk at same location as removed, unless contractor specifies otherwise. $ 21. Install new over head door with or without window of owner's choice. Install new hardware and lockset. $ 22. Install bituminous driveway. Area shall be cleared, grass removed and holes and depressions patched and filled to • obtain uniform surface. Install 4 thick base of Class #5 gravel mix or equal aggregate base compacted sub - grade. Place minimum 2" thick compressed hot plant bituminous surface, flush with grade. Machine roll to slope 1/4" per foot and in direction of proper surface drainage flow. Contractor is responsible for erecting the appropriate barriers and signs to prevent traffic movement over bituminous until it has properly set and will be responsible for any damage to adjacent work caused by the bituminous installation. All work shall be in compliance with local building codes and ordinances. Contractor must submit a drawing that illustrates the layout and dimensions of the proposed driveway. $ TOTAL • = F.EYNEPIN COLNT'_' HOUSZ?a�i ggAgzLITATxQN P FILE SUMMARY • FvxldiT2g: CDBG Der: MFFA Rev: m:BA Access: other: Client: Address : o i j r ! City; f�7L'C.�l Zip: 55 Phone App'n Reed: `� - Process Begun: ` completed: # weeks: EZigibilitY Eatablzshcd: 1 LI` q =s_ (date of earliest verificar_icn) t tit�kJ rxYk# 4! Y* t* �F�' rxt** 4****# �r** A' t* yr* if Yittt rt* tiVYft- ri' # t• l* tt* 4* t *i*ttff **kt4ff'kkyr't Aga: sex: E�hniczty: Marital StatUS: Handicapped Household: # Residents. #Renters: Age of is +use: . Years Resident: I Market Val.: S �t� Ad! uszed mkt Val = (,mkt Val x 503 :�.% loan. 1611 S �-' mortttz: S G Equity {or ad-tistec equity) : $ }• YYY' y' 9' 4* X'****] k* t** tf" I' �• i" Mi` f' �3' S' Y**' ttlY• Y' tY' F*' R�+ f*' t' ��- i' YY** ��Y`YYSe'!T]!�'t� #:l'y"f *Y•1r '.f'Ty•tt1• *�k l• * *t#•t ** For multiple incomes of one type enter totals bel o: show verifications or. r everse. Inc_-me e me sou_ce Mcnt�ly $ rifiew ?tit _n 120 cieeys? Sa la_ t — � - ^t. Self -B= ; oymer t SS _ SSi Support /Mairtenace Rent 1 Pens ior. interest - 1 5 z ' r !!.� (QRnti :ly e=e nditures : $ , •JLC Total mczt?�,ly ncame : $ � ,.�. t�,i st cn rave xA) Aff0rdac ? ity: S S of negative, within_ 5%- cf monthly Am"I' l income : $ CJ �ti' Eligible i�cc�ma fear � ' hrl c in city: � �! � V Assam s ; �` tIf verif' Ca�ion re-- -u i list on reverse) i A l ^ L ! Zoning VerifieG: �•� - ` scope Cut- t= omei�t� Bi3a_ Y TnTPL F. 0- Mayo Clinic 200 First Street Southwest Rochester, Minnesota 55905 Telephone 507 284 -2511 • Emre xokmen, M.D. October 17, 1994 Department of Neurology RE: Ms. Josephine Chamberlain 6031 Halifax Avenue North Brooklyn Center, MN 55429 -2435 Mayo Clinic #.3 -391 -600 DOB: 6 -5 -20 To Whom It May Concern: Ms. Josephine Chamberlain has a complex autoimmune disorder which manifests itself as adult onset, non - insulin dependent diabetes mellitus, myasthenia gravis, vitiligo, hypothyroidism, and pernicious anemia. She is subject to extreme fatigability; therefore, an appropriately air conditioned house is necessary for her health. • .' Emre Kokmen, M.D. EK:1kh Enclosure n ��, JL JJ '•r•+ N) 1. l `r • URBAN HENNEPIN COUNTY HOUSING REHABILITATION GRANT PROGRAM PROPERTY INSPECTION REQUEST TO COUNCIL: H APPLICANT INSPECTION Name S taff Address Date Brookivn Center, ?MN 554 Time Phone Inspector Buildin- AQe: Garage: • TABLE OF CONTENTS PART PAGE • Q HANDRAIL - GUARDRAIL $ 1 Where required, Height of, Baluster Spacing and Installation, Specification for 2 ❑ INTERIOR - EXTERIOR STAIRS $ 1 Repair or Replacement of, Rise and Run and Installation, Specification for 3 Q FOUNDATION $ 2 Repair of —Tuck Pointing Insulation Installation and Specification for 14 4 ❑ CRAWL SPACE: $ 2 Insulation of and Vapor Barrier, Installation for 5 ❑ BASEMENT FLOOR $ 2 Repair of 6 Q POST AND BEAM: $ 3 Repair of, Replace 7 ❑ ACCESSIBILITY IMPROVEMENT $ 3 For Barrier Free and Handicapped Persons ❑ ELECTRICAL 3 Upgrade Service, Unprotected Conductor,.Washer, Dryer, Hanging Receptacle, Furnace and Kitchen Circuits Wall Receptacle, Ground Fault 4 9 Q ELECTRICAL MAST: $ a Relocation of 10 Q MECHANICAL Enclosed Space Ventilation, Replace Furnace Thermostat, Chimney, Registers, Ductwork 11 ❑ PLUMBING: $ 5 Water Heater Replacement, Cold Water Shut -off, Gas Valve T.P.R. Valve, Vent Connector, Dryer Gas Valve, Dryer 6 Ventilation, Open Gas Device,Well Abandonment, Plugged Sewer, Mater Softener, Kitchen Sink Vent, Trap, !Water Supply, Lavatory Vent, Trap, Water Supply, Water Closet and Sealing Gasket, Bathtub Vent, Trap, Wall Enclosure, Laundry Tub Vent, Trap, Floor Drain Plumbina Fixture Material and Performance Specifications 7 • for, Drain Tile, Main Water Line Septic System, City Sewer g -1- TABLE OF CONTENTS PART PAC 12 ❑ CEILINGS $ Repair of • 13 ❑ WALLS: E Repair of 13 Ceiling and Wall Performance and Material Specifications for 9 -i 14 ❑ FINISH FLOORS: $ 10 -1 Rep acement of, Performance and Material Specifications for 15 ❑ EXTERIOR DOORS: $ 1 Repair - Refinish of, Weather Sealing, and Replacement of, Performance Specification for 16 Q EXTERIOR STORM DOORS: $ l Repair - Rep acement of, Material Specification for 17 ❑ INTERIOR DOORS $ 1 Repair - Replacement of, Performance and Material Specifications for 13 Q EXTERIOR STORM AND SCREEN WINDOWS: $ 1 Repair - Replacement of, Material Specification for 19 ❑ HOUSE WINDOWS $ Repair - Refinish of, Weather Sealing of, Replacement of,, Material and Performance Specification for 20 ❑ INSULATION: $ 14 -1 Attic, Wall, Foundation, Rim Joist Installation, Material and Performance Specification for, Code Requirement 21 ❑ VENTILATION: Provision of Attic, Kitchen, Bathroom, Repair of, Material and Performance Specification for 22 ❑ EXTERIOR SIDING: g 1 Installation, Repair or Replacement of, Soffit and Facia, Windcw, Door and Cornice Trim, Material and Performance Specification for 23 ❑ EXTERIOR PAINTING: 1; Materia1 and Performance Specification for 24 ❑ GUTTERS AND DOWNSPOUTS: $ l Provision for and Replacement of, Material and Performance Specification for 25 ❑ ROOFING: g R' ep - Replacement - Removal of; Material and Performance • Specification for -2- TABLE OF CONTENTS PART PAGE W26 ❑ CHIMNEY Repair Reline Replacement P of P $ 5 -19 Z ❑ KITCHEN & BATHROOM CABINETS $ 19 28 ❑ SMOKE DETECTORS Installation of 20 29 ❑ GRADING Material and Placement Specification for, Seeding and $ 20 Sodding of 30 Q EXTERIOR CONCRETE WORK Replacement - Repair of, Sidewalks, Garage Apron, Etc. $ Z0 31 ❑ MISCELLANEOUS: $ 20 TOTAL $ • Contractor Nave: Address: City State Phone: Home Work Homeowner Name: Address: Phone: H 1 Contractor Signature Date • -3- 1. INSTALL HANDRAIL: ❑ Basement Stair ❑ Front Stair ❑ Rear Stair • ❑ Upper Level Stair One handrail shall be installed on stairways 44" or less in width, except that stairways open on one or both sides shall have handrails provided on the open side or sides. Handrails shall not be less than 30" nor more than 341, in height above stair tread. Unenclosed floor, open landings and ramps at a height of over 30 from floor or grade shall have a guardrail. Guardrail shall not be less than 36" in height and shall have intermediate rails or an ornamental pattern such that a sphere 6 in diameter cannot pass through. Materials and finish shall be specified in the Scope of Improvements and installation shall be in compliance with the State Building Codes. ❑ Addition: 2.' INTERIOR - EXTERIOR STAIRS ❑ Repair ❑ Basement ❑ Second Storey ❑ Front ❑ Rear Entrance Stairs ❑ Replace ❑ Easement ❑ Second Storey Q Front C Rear Entrance Stairs Stair riser to be a minimum of 4 1! to a maxi.uum of 7 " high. Stair. tread to be a minimum of 11" wide. Wood stair stringer shall be of 2 x 10 nominal stock. Exterior stairs can be of treated stack or concrete having footings 42" minimum below grade. ❑ Addition: i 3. REPA?R FOUNDATION: ❑ A11 joints shall be completely filled with mortar. ❑ Tuck pointing shall be done only after the joints have been raked out to a minimum depth of 1/2" and wetted. ❑ Addition: 4. CRAWL SPACE: ❑ Either insulate perimeter foundation wall to R -11 or floor to a minimum of R -l9. A 6 mil. polyethylene plastic vapor barrier shall be installed over dirt area and be weighted by sand, rocks or other non -wood materials. • ❑ Addition: 5. BASEMENT FLOOR: ❑l Patch holes ara large cracks. ❑ Addition: • -2- 6. POST AND BEAM ❑ Repair or replace as marked. ❑ Addition: 7. ACCESSIBILITY Il P ROVEMENTS ❑ Refer to Minnesota State Building Code Chapter 55 for accessibility architecture specifications. The type and scope of accessibility improvements shall be at the discretion of the Grant Administrator. ❑ Addition: 8. ELECTRICAL: n Install new U.L. certified 100 amp service panel and circuit breakers. u ❑ Relocate unprotected plastic coated conductors to center of wood joist or in metal protective tubing located in ❑ Provide grounded receptacle for: ❑ Washer & Dryer on a separate 20 amp circuit. ❑ Water Softner. ❑ Other Replace hanging light or receptacle with porcelain fixture mounted on an approved box and properly grounded. ❑ Provide separate 15 amp circuit to furnace. ❑ Provide separate 20 amp circuit to kitchen countertop work area receptacles. -3- ELECTRICAL CONTINUED ❑ Add wall receptacle in; O kitchen; ❑ in dining room; bedroom ❑ bedroom bedroom bedroom Q ❑ ❑ living room bathroom ❑ with ❑ without ground fault. ❑ laundry room ❑ Addition: 9. ELECTRICAL MAST; ❑ Relocate Q Other ❑ Addition: ALL ELECTRICAL WORK Sr?dLL EE IN COMPLIANCE TO THE NATIONAL ELECTRICAL CODE. 10. MEC ANICAL: ❑ Provide ventilation of enclosed furnace space. ❑ Provide heat loss calculation of dwelling and install new heating manufacturer's instructions capable to meet the heat loss. The minimum AFUE shall be listed at 80n and shall include damper efficiency. New appliance shall be AGA or UL listed and orsat tested. -4- ❑ Replace gas valve with approved lever handle gas valve or ball valve ❑ Replace vent connector from furnace to chimney with 26 gauge galv. sheet metal vent materials. ❑ Provide combustion air [] Provide set back thermostat. ❑ Reline existing Class B Chimney to expel water heater or other gas appliance combustion gases if new heating appliance is vented through the side wall. ❑ Remove ❑ Reline existing Class B Asbestos Chimney. ❑ Add warm air re in Q Add return air register in ❑ Add Duct work ❑ Addition: ALL IECL?NTCAL WORK SrQLL BE IN CCPTLIANCE WITH STATE MK'C CODES. 11. PLUNKING ❑ Install new gallon energy miser water heater having AGA or UL listing complete with necessary gas piping tested for leaks, new lever handle gas valve or ball valve, new vent connector sealed and secured at all joints, new temperature pressure relief valve with 3/4 overflow tube extending to 6" above finished floor. Water heater shall be warranted for five years. ❑ Install cold water shut off valve on existing water heater. ❑ Install approved aas valve on existin water heater. P _ 9 a ..r. -5- i PLUMBING continued ❑ Install temp., pressure, relief valve on existing water heater. ❑ Install new vent connector on existing water heater. ❑ Install new approved gas valve on gas dryer. ❑ Vent gas dryer to outside air. ❑ Plug or cap open gas valve or fitting located at or near [j Disconnect existing well water and reconnect water service to City water with meter and reconnect electrical around to City side of water meter. Well to be properly abandoned, inspected and approved by the State Health Department or City Sanitarian. ❑ Rout out main house sewer and clear stoppage. ❑ Repair or replace inoperable water softener. Install new kitchen sink vented to outside air. install new kitchen sink `Hater supply tubes and valves. Install new kitchen sink tap. C.1 install new lavatory sink Tented to outside air. Q Install new bathroom lavatory water supply tubes and valves. ❑ Install new bathroom lavatory trap. Q Install new bathroom water closet complete with seat and shut off valve.* Q Install new water closet setting seal gasket. ❑ Install new bathtub vented to outside air. Q Install new bathtub waste trap. ❑ Install new bathtub wall enclosure and shower curtain rod. ❑ install new laundry tub vented t.o outside air. ❑ install new laundry tub waste trap. F ❑ loor Drain Q Inoperable ❑ Install ❑ Other PLUMBING continued Q New kitchen sink shall be 33" x 22" self- rimming, unless otherwise specified in the Scope of Improvements. Sink shall be stainless steel or cast iron and faucets shall be either single lever or two handle. a. Garbage disposal is only an acceptable work item in these two circumstances. ❑ 1. reinstallation of existing disposal when installing a new sink. ❑ 2. removing and disposal. Q New bathtub shall be cast iron, fiber-!as or steel. Faucets shall either be single lever or two handle. Color selection shall be limited white unless specified to match existing color. Installation of a fiberglas tub insert is at the discretion of the Grant Administrator. Q New lavatory shall be wall -hung or with vanity. Trap shall be .17 gauge. Color selection shall be limited to white unless specified to match existing color. Refer to Carpentry section for dabinet specification. Q New water closet shall be viterous china with close coupled tank, include seat and anti- siphon ballcock. Go'-or selection shall be limited to white unless specified to match existing color. Q New laundry tub shall be fiberglas and securely attached to wall or free standing. Faucet shall be stainless steel or brass type and nonthreaded or with a vacuum breaker. [] Provide basement interior perimeter wall drain tile system and floor sump pump. Sump pump shall discharge to an exterior french drain or City storm sewer. French drain shall be located a minimum of ft. from foundation - wall and be filled with a minimum of cubic feet of 3/4 stone. Stone shall be topped with sod or reseeded to match existing landscape. ❑ Addition: Q Provide municipal Water - House connection to municipal water line shall entail a bid specifyirg muni c pal tap -in fee, total length and cost per foot, location and permit. Connect to house supply lines, patch any unnecessary holes incurred where water line enters 'rouse, repair any necessary street damage, back fill and mound to allow settlement to previous ground level. Seeding or sodding the ground to match existing or blend in with the adjoining and surrounding work shall be at the discretion of the Grant Administrator. Q Addition: -7- PLUMBING continued ❑ Provide Septic Sewage System -System shall be specified in the bid and include drawing. Installation shall include testing and permit costs. Connect to house drainage lines provide g � P reasonable protection to lawn, driveways, etc., back fill and mound to allow settlement to previous ground level. Seeding or sodding the ground to match existing or blend in with the adjoining and surrounding work shall be at the discretion of the Grant Administrator. ❑ Addition: Q Provide Municipal Sewer - House connection to municipal sewer line shall entail a bid specifying municipal tap -in fee, total length of line and cost per foot, location and permit. Connect to house drainage lines, patch any unnecessary holes incurred where line enters house, repair any necessary street damage, fill existing septic tank(s) with dirt and back fill and mound to allow settlement to previous ground level. Seeding or sodding the ground to match existing or blend in with the adjoining and surrounding work. ❑ Addition: ALL PLUMBING WORK SHALL BE I.N CCMTLIANCE WITH THE STATE PLUMBING CODE 12. CEILINGS (See General Specification) ❑ Repair Ceiling in ❑ {itchen ❑ Dining room ❑ Livingroom ❑ Bathroom Bedroom ❑ Bedroom ❑ Bedroom ❑ Bedroom ❑ Basement Q Basement ❑ Closet Af 13 . WALLS (See General Specification) Repair Wall in ❑ Kitchen [] Dining room ❑ Livingroom ❑ Bathroom ❑ Bedroom ❑] Bedroom ❑ Bedroom ❑ Bedroom ❑ Basement ❑ Closet of -8- WALLS continued ❑ Wall and Ceiling Repair General Specification: 1• wherever existing walls or ceilings are to be repaired, the damaged and loose material shall be completely removed and new material shall be sized and installed to match and blend in with the adjoining and surrounding work. All repairs shall be properly prepared to receive the finish application. 2. Plastering - New plastering work shall be installed in compliance with the State Building Codes. 3. Wall Board - shall be installed in compliance with the State Building codes. u. Perforated Tape Mix - shall comply with the recommendations of the manufacturer. A minimum temperature of 55 degrees Fahrenheit shall be maintained in the room where work is done until the cement is completely dry. 5• Perforated Tape Application - Follow manufacturer's directions. a. Over Joints the tape shall be embedded in cement and covered with a thin layer of cement. A second and third coat shall be applied. Each coat shall be dry before applying the next coat. Each coat shall be featheredged and extended beyond the previous coat (approximately 2 . Z"ne finish coat shall be sanded lightly and any imperfections filled in prior to any painting and decorating. b. Check to see that all nails have been driven so that their heads are below the surface of the board leaving a dimple in the surface without breaking the paper. Cover the nails dimple with three applications of cement allowing time to dry between each coat. The final coat shall be sanded lightly before application of paint or other decoration. c. Inside corners shall be reinforced with tape embedded in cement finished as specified "Cver Joints ". d. Cutside corners shall be protected by wood moulding, metal moulding or metal corner reinforcement. Metal corner reinforcement shall be finished with two coats of cement as specified. 6. Waterproof gypsum board shall be used in areas specified in the State Building Code. Install water resistant wall board base in the bath and shower enclosure, and apply wall board with long edge horizontally over the tub, allowing 1 /4" space between the board and tub. 7. Adhesive is an acceptable bonding material. Adhesive shall be specified according to usage and location and applied in strict compliance with the manufacturer's specifications. -9- WALLS continued 8. Paneling installation shall be 3/16" prefinished paneling of a medium quality installed as per manufacturer's recommendations. Owner shall have choice of paneling color and style. 9. Furrinj strips - New ceiling shall be installed over 1" x 3" furring strips, 12 on center. When ceiling butts to wood or paneled walls, 3/4 to 1 112" cove moulding shall be installed along edge. New walls shall be installed over 1 x 2 furring strips,. 16" on center. Any existing baseboard, window or door trim shall be removed and reinstalled or replaced with new trim over new wall material, unless otherwise specified in the Scope of Improvements. New work shall be level and plumb with adjoining and surrounding work. Addition: 14. FINISH FLOORING Replace Floor Covering in :kitchen Dir_ingrocm Livingrcom Bathroom Bedroom Bedroom Bedroom Bedroom Basement Closet of 1. Existing wood flooring shall be repaired to match existing or blend in with the adjoining and surrounding work. 2. Resilient flooring shall be sheet vinyl or vinyl asbestos the minimum thickness 1/16" . Tile shall be medium quality and laid inexact accordance with the manufacturer's specifications. pecif i cations. Cwner to select color and pattern from readily available selection. 3. Carpet shall be a color and pattern from readily available selection of medium quality and priced carpet. 4. A finished wood, vinyl or metal mouldin- along ed install e F finish g P oe of flooring shall be d as part o � . the finish flooring installation. -10- FLOORING continued 5. Plywood used as subfloor shall be a minimum of 1/2" thick, nailed to joist spaced 16 on center along intermediate members, installed with outer plies at right angles to the joists and staggered so the end joists in adjacent panels bear on different joists. 6. Underlayment shall be 1/4 structural grade plywood, particle board or untempered hard board placed with smooth side up. [] Addition: 15. EXTERIOR DOORS Repair and Refinish: [j Front Eoor ❑ Rear Door ❑ Side Door ❑ Garage Door weather Seal: ❑ Front Door ❑ Rear Door ❑ Front Storm Door ❑ Rear Storm Door C Replace: Front I'r =r ❑ ,or Q xe�: Door ❑ Garage Door All exterior doors shall be solid core wood or insulated steel and complete with hardware, strike plat and lock set. Installed doors shall be orehung or sized to fit frame complete with stops, weatherstripping and jambs. After trimming and fitting of door, all edges shall be finished to match existing or blend in with the adjoining and surrounding work. A door bumper and threshold are included on all exterior doors. 16. EXTERIOR STORIM DOOR ❑ Repair: ❑ Front Storm Door ❑ Side Storrs Door ❑ Replace: ❑ Front Storm Door ❑ Side Storm Door Storm doors shall be solid core aluminum or wood wi th Storm and screen inserts and complete with hardware and strike plate. Installed doors shall be sized to fit frame. All edges of wood storm shall be finished to match existing or blend in with the adjoining and surrounding work. 17. INTERIOR BOORS ❑ Repair Door to: ❑ Basement ❑ Bathroom ❑ Bedroom Q Bedroom ❑ Bedroom Q Bedroom ❑ Closet in Replace Door To: ❑ Basement ❑ Bathroom ❑ Bedroom Q Bedroom ❑ Bedroom ❑ Bedroom ❑ Closet in Interior doors shall be hollow core or pane.I � � r 4 c, r and complete with har and t. i �ke plate. Installed doors shall be crehung or sized to fit frame complete with stops and jambs. After trimming and fittirg of door, all edges shall be finished to match existing or blend in with the adjoining and surrounding work. A door bumper is included on all interior doors. Bathroom door shall be provided with "privacy" lock set. ❑ Addition: 18. EXTERIOR STORM AND SCREEN WINDOWS ❑ Repair 0 Replace ❑ Basement Q Kitchen ❑ Diningroom Livingroom ❑ Bathroom i ledroom Bedroom ❑ Bedroom Q Bedroom Storm windows shall be aluminum combinations of medium quality, unless otherwise specified in the Scope of Improvements. 19. HOUSE WINDOWS ❑ Repair and Refinish Windows in: ❑ Basement ❑ Kitchen ❑ Diningroom ❑ Livingroom ❑ Bathroom Q Bedroom ❑ Bedroom ❑ Bedroom ❑ Bedroom Repair of windows or replacements of frames, sills, sash, trim and hardware shall match existing work in wood, design, dimensi3ns and finish, unless otherwise specified in the Scope of Improvements. Where sash counter balances are to be removed, the area must be insulated properly. Friction guides are acceptable as substitutes. Cotton cord replacement is acceptable. A positive locking device shall be installed on all windows. All broken glass shall be replaced with new glass, matching existing in size and design and properly reglazed. All excess material shall be removed and all glass left clear.. Weather Seal Windows in: ❑ Kitchen E7 Diningroom ❑ Livingroom ❑ Bathroom ❑ Bedroom ❑ Bedroom ❑ Bedroom Q Bedroom ❑ Basement Caulk and weatherstrip around all primary door and window frames, window panes or other locations that lead to an unheated space or which calls for a seal and watertight job. Materials shall be of standard brands and application shall be in exact accordance with the manufact'urer's specifications. -13- Replace Window in: Kitchen ❑ Diningroom ❑ Livingroom ❑ Bathroom Q Bedroom ❑1 Bedroom ❑ Bedroom [] Bedroom ❑ Basement Openings of new window units shall be framed to provide a rigid enclosure for the installation of windows. Frames shall be set plumb, level and square within clearance limits. New windows shall match the adjacent windows in design, glass, material and finish, unless otherwise specified in the Scope of Improvements. Installed windows shall be weathers tripped, left clean, tight and weatherproof. ❑ A positive locking device shall be installed on all windows. ❑ Installed below grade bedroom window used as an excape exit shall have a opening size of not less than 5.7 sq. ft. with a minimum of 24" depth and 20" Width. The interior sill height shall not be more than 48" from floor. Exterior of window shall be cleared for exit and when an areawell is installed it shall be of treated wood or galvanized metal. ❑ When a bedroom window unit is replaced, the new unit shall be sized to meet the requirements of the State Building Codes. ❑ addition: 20. INSULATION ❑ Insulate attic space to meet a minimum R -38 rating and have a vapor barrier, where accessible. Air chutes shall be installed where there is soffit venting. Provide protection around all recessed lights, junction boxes and chimney. Access opening shall be sized a minimum of 22" x 30 ", framed and insulated. ❑ Insulate exterior walls to a minimum of R -11. Drill holes and blow in insulation between wall studs approximately every 10" on center and below each fire stop. Holes shall be patched to match existing or blend with adjoining and surrounding work. [❑ Insulate exterior foundation. with rigid insulation {of R -11 to above grade and extend insulation 2' below grade and cover insulation with a non - combustible material. Foundation insulation shall be at the discretion of the Grant Administrator. -14- INSULATION continued ❑ Insulate accessible area rim joist to a minimum of R -19 with vapor barrier facing warm side. Addition: 21. V EVTILAT_ON ❑ Provide attic ventilation per Uniform Building Code as follows: Ventilation - where determined necessary by the building official due to atmospheric or climatic conditions, enclosed attics and enclosed rafter spaces formed where ceilings are applied direct to the underside of roof rafters shall have cross ventilation for each separate space by ventilating openings protected against the entrance of rain and snow. The net free ventilating area shall be not less than 1/150 of the area of the space ventilated, except that the area may be 1/300, provided at le .. •� 50,E of the require ventilating area is provided by ventila located in the upper portion of the space t ve L' ee f et above o be a �t least �nr.. eave or cornice vents with the balance of the required ventilation provided by eave or cornice vents. The openings shall be covered with corrosion - resistant metal mesh with mesh openings of 1/4" in dimension. ❑ Provide kitchen ventilation. - Exhaust Fan - kitchen without means of natural or below minimum requirements of ventilation shall be equipped with a mechanical exhaust fan. Installation shall include mounting fan on ceiling, venting through the roof or exterior wall with cap, insulating vent in unheated space and wiring on a separate wall switch. ❑ Repair kitchen ventilation. ❑ Provide bathroom ventilation - Exhaust Fan - Bathroom without means of natural or below minimum requirements of ventilation shall be equipped with a mechanical exhaust fan. Installation shall include mouting fan on ceiling, venting through the roof or exterior wall with cap, insulating vent in unheated space and wiring on a separate wall switch. ❑ Repair bathroom ventilation.. ❑ Addition. -15- 22. EXTERIOR SIDING ❑ Repair or replace all rotten boards and nail down all loose boards or shingles prior to receiving new siding. Side walls shall be furred out if necessary to make walls level, plumb and free from waves, buckles and sags. Installation shall be in strict compliance with the manufacturer's specifications. . ❑ Existing brick work shall be repaired to match existing or blend in with the adjoining and surrounding work. ❑ Reside exterior with .024 gauge, nominal thickness, insulated type aluminum of medium quality or equal. Color selection by owner. Installation shall include window J channel, door channel, inside and outside corners, starter strip, finish mould and caulking. Backi ng shall be installed under siding and be of proper thickness. All nails and rivets shall be properly secured. Staples shall not be used for installation. ❑ Cover all window, door trim and sills with baked enamel aluminum, minimum .019 gauge. Color selection by owner. Lao - Siding shall be minimum 7/16" thick x 16" long, smooth, pre - primed masonite panels. Siding shall be installed with corrosion resistant rails and all ' ends shall be attached together with H- moulding and sealed with exterior caulking. Lap Siding shall extend to 6 above finish grade. Novelty - Cover indicated sections of structure with new wood novelty siding, or other specified material. All joints shall be tight and adjacent end joints shall be staggered. Siding shall be installed over vapor barrier, blend and conform with existing structure. All horizontally applied siding . shall be staggered with minimum of two stud spaces. ❑ Cover soffit and fascia with .019 gauge baked enamel aluminum using solid or perforated soffit material. Color selection by owner. Soffit panels shall be secured in charnels to eliminate looseness and rattling. :"aterials shall be lapped for proper drainage and applied in full sections. Caulk joints. Staples shall not be used for installation. ❑ Addition: -lo- 23• PAINTING [] Repaint exterior siding, cornice, window and door trim including doors and windows as follows Wood surfaces to be painted shall be cleaned by best means possible to remove loose and scaley paint and rough spots any any obvious oil and /or grease that may be covering existing wood or paint. Where previous coats have chipped and peeled, the edge shall be feathered to the maximum extent feasible and spot primed with a high quality oil base paint before finish coats are applied. No paint shall be app lied until all rail holes have been filled and sanded and all defects in wood work have been eliminated. Paint shall be medium grade and applied according to the manufacturer's specifications and applied to secure full coverage. Use primer where required. Owner to select color from readily available selection. Spray application is not acceptable, unless authorized by the Grant Administrator. 24. GUTTERS AND DOWN SPCUTS ❑ Provide gutters and down spouts as follows: a) New gutters shall be minimum 5" wide .032 gauge aluminum with hangers placed under roofing. b) New downspouts shall be minimum 2" x 3 " rectangular .020 gauge aluminum. C) Finish of gutters and downspouts shall be a baked on enamel finish. Owner to select color from readily available selection.. d) Gutters shall be installed with slight pitch to the downspout. Gutters shall be securely mounted to the roof, 36" or less on center. Downspouts to be installed at one end of gutters and extend 2' at the bottom with extension. atension or splash block shall be installed when the gutter and downspout system does not directly connect into a drainage system. ❑ Addition: -17- 25. ROOFING ❑ Provide new roof per City of Brooklyn Center P�andout and as follows: New roofing shall be in compliance with the State Building Codes a nd `�anufacturer's installation instructions. Flashing, n° roof vents shall be checked and replaced with new when damaged rusted or missing. Drip edge shall be installed along eave edge. All damaged or rotted sheathing boards shall be replaced with new. End joints shall be made over a rafter and all sagging portions of roof shall be corrected. Materials - New roofing shall carry the Class C label of wind resistance from the rt Unde. .�riter } s Laboratories a i� and be applied according to the manufacturer's acturer s specifications. The type and weight of the materials used for the roofing shall be in compliance with the State Building Codes. Application - Surfaces to which roofing is to be applied shall be even, sound, thoroughly clean, dry and free from all defects that might affect the quality of application. a) Asphalt Shingles - No more than one overlay of asphalt shingles shall be applied over an existing asphalt shingle roof. Shingles shall be fastened with not less than four nails or staples per shingle. Installed shingles shall be 23--;f - 240# 3 -tab self sealing. Roll roofing shall be installed when the slope is 4" or less. Owner to select color of shing l es from readily available selection. b) Built -up - Existing roofing material shall be removed down to bare wood. New roofi. shall be 4-ply built-up '� i p Y tar and slag or gravel roof, including all new flashing of either metal or asphalt mineral roil material. Roof shall be installed in such a way that there is no pondirg water. c) Wood Shingles and Shakes - Repair of existing roof shall match existing or blend in with the ad�oinin-- and J 0 surrounding work and include a contractor warranty for the repair work. d) Fiberglas - is an acceptable roofing material. ❑ Tear off existing roof and remove from site. Addition: -18- 26 • CHIMEY ❑ Repair or replace missing brick. ❑ Tuck pointing hall be done e only after the joints have been raked out to a minimum depth of 1/2" and wetted. ❑ Provide masonry chimney cap. ❑ Addition: 27. KITCHEN AND BATHROOM CABINETS ❑ Repair damaged kitchen cabinets. Repair damaged bathrocm lavatory cabinet. ❑ Replace or add kitchen cabinets: 1 1ew cabinets shall be described in complete detail, including design, dimension, installation and location of top or base units, detail of drawers, doors and shelves, type of material and finish in the Scope of Improvements. The contractor shall submit a drawing of the proposed cabinets. ❑ Replace bathroom lavatory cabinet: Vanity - lavatory base cabinet shall be medium quality. Top shall be approximately 22" wide with 3 back splash and covered with formica preformed or self edge top. Imitation moulded marble tops can be used as a substitute. ❑ Replace kitchen cabinet top: Kitchen Counter Top - shall be self edge or self forming formica with 4 11 backsplash. Separate backsplash material shall match formica counter top material. ❑ Replace bathroom lavatory vanity: Vanity - lavatory base cabinet shall be medium quality. Top shall be approximately 22" wide with 3 back splash and covered with formica preformed or self edge top. Imitation moulded marble tops can be used as a substitute. ❑ Provide bathroom medicine cabinet: Cabinet - shall be standard size recessed, or surface mounted, with a minimum of three shelves and mirror. 'When light fixture is included, fixture shall be wired on separate wall switch. -19- 2$. SI^OKE DETECTORS ❑ Install UL listed battery - operated smoke detector per manufacturer's instructions without escape light complete with working batteries. 29. GRADING ❑ Provide grade fill as follows: ❑ Grade - Fill material shall be free of debris or other detrimental material. All fill shall be compacted to a density that will avoid damaging settlement to lot improvement. Top soil shall be a minimum of 4" compacted depth and free from stones, debris and other materials detrimental to plants. Slope away from building, 4 over a distance of 3 1 - 1 4' out from wall. Foundation walls shall extend at least 6 above the finished grade adjacent to the wall at all points. ❑ Seeding and Sodding as reeuired. 30. EXTERIOR CONCRETE WORK ❑ Replace crumbled or broken sidewalks. ❑J Replace crumbled or broken garage entrance apron. 31. t ESCELL MECUS I -CJ- Commissioner introduced the following resolution and moved • its adoption: EDA RESOLUTION NO. RESOLUTION APPROVING ONE (1) BROOKLYN CENTER ECONOMIC DEVELOPMENT AUTHORITY DEFERRED LOAN (FILE NO. H -128 [80541) WHEREAS, the Brooklyn Center Economic Development Authority established a Home Rehabilitation Deferred Loan Program to assist low and moderate income individuals in the maintenance and repair of their homes; and WHEREAS, the Brooklyn Center Economic Development Authority has received one (1) application (file no. H -128 [8054]) from eligible individuals to receive deferred loan assistance; and WHEREAS, an inspection by the City of Brooklyn Center has determined that the work is necessary and appropriate under the Brooklyn Center Economic Development Authority Deferred Loan Program; and WHEREAS, the estimated cost of the proposed deferred loan application is estimated at $15,000. NOW, THEREFORE, BE IT RESOLVED by the Brooklyn Center Economic Development Authority that: 1. The Brooklyn Center Economic Development Authority does approve the one (1) housing rehabilitation deferred loan application (file no.H -128 [8054]) as recommended by the staff. 2. That the work be performed as recommended in the request for council consideration form dated January 23, 1995, and that the applicant be directed to obtain the necessary bids for staff review and approval. 3. The project shall not exceed the deferred loan limit of $15,000. Date President The motion for the adoption of the foregoing resolution was duly seconded by commissioner and upon vote being taken thereon, the following voted in favor thereof: and the following voted against the same: s whereupon said resolution was declared duly passed and adopted. Council Meeting Date 1 -23 -95 City of Brooklyn Center Agenda Item Number U Request For Council Consideration Item Description: RESOLUTION APPROVING ONE (1) BROOKLYN CENTER ECONOMIC DEVELOPMENT AUTHORITY GRANT (FILE NO. H -129 [80551) Department Approval: Thomas Bublitz, Community Development peci fist Manager's Review/Recommendation:� -���- No comments to supplement this report Comments below /attached Recommended City Council Action: Staff recommends motion to adopt Resolution approving one (1) Brooklyn Center Economic Development Authority Grant (File No. H -129 [8055]) Summary Explanation: (supporting documentation attached ) This information is private and not available to the general public. I have received one (1) application for a rehabilitation deferred loan (File No. H -129 [8055]). Attached is the application and recommendation for work to be performed on the home. The applicant filed the initial application for deferred loan program on October 22, 1992 which is the date that established the applicant's position on the deferred loan program waiting list. The application dated October 6, 1994 is the date of the applicant's formal income verification application which is completed by Hennepin County staff once the application reaches the top of the waiting list. The home /applicant has not received a previous grant under the program. The 1994 market value for File No. H -129 [8055] property is $72,600 and the exterior of the home does not meet the EDA's exterior maintenance requirements. • • H -129 . Page 2 The applicant has made a special request regarding the repayment agreement for the deferred loan. The repayment agreement provides for a ten year lien period in which the loan debt declines each year for ten years and ultimately zeros out at the end of ten years as long as the owner remains in the home. The applicant has requested that, if his property is ever acquired through eminent domain, for a road project on Humboldt Avenue, the City's Deferred Loan will be forgiven. This is a standard practice in many cities and staff has no objections to this request. The majority of the rehabilitation that will be done on the house will not add significant value to the house so the owner will not experience a cash windfall from the deferred loan home improvements should his home be acquired through eminent domain. I would recommend, however, that this be accomplished by a letter in the loan file reflecting the loan forgiveness rather than amending the repayment agreement. The City Attorney has agreed that the loan forgiveness could be accomplished through a letter to the file. • �b Commissioner introduced the following resolution and moved • its adoption: EDA RESOLUTION NO. RESOLUTION APPROVING ONE (1) BROOKLYN CENTER ECONOMIC DEVELOPMENT AUTHORITY DEFERRED LOAN (FILE NO. H -129 r80551) WHEREAS, the Brooklyn Center Economic Development Authority established a Home Rehabilitation Deferred Loan Program to assist low and moderate income individuals in the maintenance and repair of their homes; and WHEREAS, the Brooklyn Center Economic Development Authority has received one (1) application (file no. H -129 [8055]) from eligible individuals to receive deferred loan assistance; and WHEREAS, an inspection by the City of Brooklyn Center has determined that the work is necessary and appropriate under the Brooklyn Center Economic Development Authority Deferred Loan Program; and WHEREAS, the estimated cost of the proposed deferred loan application is estimated at $15,000. NOW, THEREFORE, BE IT RESOLVED by the Brooklyn Center Economic Development Authority that: 1. The Brooklyn Center Economic Development Authority does approve the one (1) housing rehabilitation deferred loan application (file no.H -129 [8055]) as recommended by the staff. 2. That the work be performed as recommended in the request for council consideration form dated January 23, 1995, and that the applicant be directed to obtain the necessary bids for staff review and approval. 3. The project shall not exceed the deferred loan limit of $15,000. Date President The motion for the adoption of the foregoing resolution was duly seconded by commissioner and upon vote being taken thereon, the following voted in favor thereof: and the following voted against the same: . whereupon said resolution was declared duly passed and adopted. MEMORANDUM • TO: Tom Bublitz Community Development ty e elopment Specialist FROM: David Fisher, Building Inspector DATE: December 22, 1994 SUBJECT: Rehabilitation grant for 7013 Humboldt Avenue North Owner: Charles & Laurel Hurley H -129 (8055) The subject property is a 3 bedroom rambler built in 1968. The exterior siding, soffit and fascia is in need of upgrade. The City Assessor has valued this property at $72,600. The following scope of improvements and work proposal will help bring this dwelling up to code. URBAN HENNEPIN COUNTY HOUSING REHABILITATION PROGRAMS CONTRACTOR BIDDING INSTRUCTIONS WHE CONTRACTOR SHALL SUBMIT A CONSTRUCTION BID PROPOSAL THAT COMPLIES WITH THE FOLLOWING CONDITIONS. REFER TO BASIC GENERAL SPECIFICATIONS AND WORK CONTRACT FOR FURTHER CONTRACTUAL INFORMATION. Bid - The Construction Bid shall entail a write -up of complete specifications for the proposed rehabilitation work. Write -up shall specify brand names, materials, dimensions, itemized cost, finishing and include all labor, equipment, and services required for proper completion of the work. Scope of Improvements and Work Proposal - The contractor is requested to use the prepared Scope of Improvements and Work Proposal form as the contracting bid when bidding the rehabilitation work. A contractor's bid written up on a different form will be accepted only when the bid is complete with detailed work specifications and includes the individual cost per item. However, the Scope of Improvements shall take precedence over other specifications and when in conflict, the material, equipment, or workmanship, as called for in the Scope Improvements will be required. Requested drawings are for clarification /illustration purposes. Materials - Installed materials shall be new, of medium quality and grade. Owner shall select colors or patterns furnished by the contractor from readily available supplier's selection. If a cost allowance is specified, and the color or pattern selected is more than the allowance, the owner shall pay the cost difference. Workmanship shall be in accordance with trade standards. Installation and /or application shall be in compliance with the manufacturer's specifications and /or comply with applicable codes and eir requirements. All operational manuals for new installed equipment shall be provided to the owner. Existing Systems - When the Scope of Improvements specifies plumbing, electrical or mechanical work, involving the existing system, the contractor shall submit a bid for the code work which has not been listed in the Scope of Improvements and which would be required in order for that entire system to comply with the minimum housing standards and /or code requirements. Alternatives - The contractor may submit an alternative bid that is written up on a separate form titled "Alternatives ", when an item is not listed and /or when the contractor feels that there i5 a better method for the corrective work than what has been proposed in the Scope of Improvements. The alternative bid does not relieve the contractor from bidding the item as written up in the Scope of Improvements. Regulations and Licenses - it is the responsibility of the contractor to execute proper regulation procedures and to obtain all licenses and permits as required by governing agencies (MN Occupational Safety and Health Administration, MN Pollution Control Agency, MN Dept. of Health, etc.) when working with materials that may cause possible health and environment - related risks, such as, but not limited to, asbestos and lead. URBAN HENNEPIN COUNTY HOUSING REHABILITATION PROGRAMS CONTRACTOR BIDDING INSTRUCTIONS (CONTINUED) Lead Paint - Exterior and interior paints, enamels and primers used on any surface in structure constructed or rehabilitated through the Urban Hennepin County Housing Rehabilitation Programs will no contain more than six one - hundredths of one per centum lead by weight (calculated as lead metal) in the total nonvolatile content of the paint or the equivalent measure of lead in the dried film of paint already applied. Codes - The contractor shall give all notices required by and comply with all applicable building codes and regulations of the local building inspection department including the obtaining of and payment for any required permits; provided that the contractor shall not be held responsible for pre - existing violations. Except any and all new replaced work included in the contract will be required to comply with such codes or regulations. Before beginning the work, the contractor shall examine the Scope of Improvements for compliance with the applicable codes and regulations for the new or replaced work and shall immediately report any discrepancy to the owner or program administrator. Damage to Property - When adjacent property is affected or endangered by work done under contract, it shall be the responsibility of the contractor to take whatever steps are necessary for the protection of the adjacent property and to notify the owner there of such hazards. Surplus Materials - all surplus materials delivered to the job site and all materials, fixtures and equipment removed and not reused shall remain or become the property of the contractor and the subcontractors and shall be removed from the job site promptly after completion of the work, as well as all rubbish and debris resulting from the contractor's operations. The premises shall be left in broom -clean conditio• Site Condition - The contractor shall be held to have visited the site and checked with the owner about the working conditions and the methods of carrying out the work. The owner shall permit the contractor to use, at no cost, existing utilities, such as light, heat, power, and water, necessary to cant' out the completion of the work. General Contractor - The contractor shall be responsible for the fitting of all work and for the coordination of the operations of all trades, subcontractors or material persons as required for proper completion of the rehabilitation work. Bid Rejection - Bids or proposals will be submitted at the bidder's risk. The owner and /or administrating entity reserves the right to reject any or all bids or proposals. page 2of2 SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: CDBG Deferred Loan Program PROPERTY: 7013 Humboldt Ave N CARPENTRY $ 1. Install new vinyl siding. Remove existing siding and fasteners. Repair framing and substrate as feasible to provide plumb, sound and even base for new siding. Install Tyvek or equal moisture barrier, flashing and sealant as required to provide weathertight walls. All accessories shall match siding, unless contractor specifies otherwise. Owner's choice of color and design of siding. . Allside, Alcoa or equal. Rework items that interfere with the siding installation. New siding shall be installed to line with lap as recommended by manufacturer. Joints shall be distributed uniformly throughout each area. Install flashing over heads and below sills of openings and elsewhere as required to provide a watertight wall. Install corner closures, as appropriate to the type of siding and secure siding in place, using fasteners as recommended by manufacturer. All accessories shall color match siding. Installation to meet State and local building codes and/or manufacturer's specifications (whichever is most restrictive). Option: Specify separate cost to insulate exterior sidewalls with blown insulation, UL listed $ $ 2. Cover entire eave area with .019 baked enamel prefinished aluminum, Alcoa or equal. Replace rotten and damaged boards. Materials shall be lapped for proper drainage. Apply aerated material to vented soffit area and ensure soffit venting that is open to attic area for unobstructed air flow. Owner's choice of color. $ 3. Cover entire trim area around windows and doors with .019 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Materials shall be lapped for proper drainage. Owner's choice of color. Bid submitted by (subcontractor /tradesperson) i SCOPE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program • PROPERTY: 7013 Humboldt Ave N CARPENTRY, continued $ 4. Install egress window in basement bedroom, casement type and size for egress. Confirm window location with owner. Install new unit with new hardware, caulking, weather - strippingng, locking device, insulating glass, screen, framing and casing for complete assembly. Marvin or equal. Metal clad exterior covering shall be with thermo- barrier. Apply painter's finish to wood of owner's choice. Install areawell of galvanized metal or treated wood of owner's choice around exterior of window. Fill base of areawell with V -0" drainage rockfill. Areawell shall be sized for easy exit from window opening. If depth of areawell is 30" or more, contractor shall consult with local building department for code requirements. Installation shall be in compliance with State and local building codes. 3. Form new concrete or wood step at rear exit to garage. Place on grade with masonry or cast -in -place foundation wall and concrete footing extending below frost line. Broom finish concrete. • Reinforce and anchor to building as necessary for - structural integrity. Install per State and local building codes. Same size and location as removed, unless conflicting with code or contractor specifies otherwise. $ Concrete $ Wood $ 5. Repair window, south side of house. Rework and repair all damaged or deteriorated members of sash and jamb. Repair or replace damaged locks, stops, glides and glass, weatherstripping and cranks. $ 6. Install UL listed door closer on door from garage to dwelling. Bid submitted by (subcontractor /tradesperson) SCOPE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program PROPERTY: 7013 Humboldt Ave N MECHANICAL $ 1. Install new furnace. Remove existing unit and haul away debris. Install a new forced -air heating unit, AGA or UL listed, Carrier or equal, that will maintain a safe and adequate heat supply to each conditioned room in the dwelling unit. The installed unit shall be designed to meet or exceed 80 % annual fuel utilization efficiency. Installation shall include combustion air intake and new thermostat. New unit shall be vented to an approved flue. Bid shall specify condition of existing flue, if flue needs replacement, and cost of replacement if necessary. Reconnect to plenum. Wire on separate circuit. Installation shall be in compliance with manufacturer's specifications and local building code requirements. Bid shall specify the brand name, BTU /size and AFUE of installed heating unit. $ 2. Install supply and return air ducts in basement bedroom and pink O room. $ 3. Install a new gas shut -off valve for range. AGA approved; ball type with lever handle. Locate within 3' -0" of range. Must be readily accessible. $ 4. Install a new gas shut -off valve for unused dryer line and cap at shut off. AGA approved; ball type with lever handle. Must be readily accessible. Bid submitted by (subcontractor/tradesperson) 1 • SCOPE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program • PROPERTY: 7013 Humboldt Ave N PLUMBING - All work performed shall be in compliance with the State and local applicable plumbing code requirements. The system shall be in a health -safe and in proper working order. Contractor shall be responsible for obtaining all necessary permits prior to starting work. $ 1. Install a new 40 gallon, energy saver, natural gas, AGA or UL listed, water heater; State or equal. Properly connect to gas line, plumb and vent unit. Haul away old unit. Consult building inspector for preferred location. Alternate: If water heater not replaced, extend drop tube for TPR valve on existing water heater. $ $ 2. Replace ballcock in rear bathroom toilet per Minnesota State Plumbing Code: Anti - siphon with minimum 1" airgap between underside of vacuum- breaker and top of overflow tube; overflow tube must be 5/8" above indicated water level marked in tank. Fluidmaster or equal. • $ 3. Install an approved hose connection vacuum breaker, ASSE 1011 CASH -ACME VB -222 or equal on laundry tub and all outside sillcocks. $ 4. Remove unused water softener. $ 6. Remove unused toilet in basement and cap drain to code. $ 6. Code plumbing system. Specify all other plumbing code work not listed above and the cost per work item. Bid submitted by (subcontractor /tradesperson) j SCOPE OF IMPROVEMENTS AND WORK PROPOSAL • PROGRAM: CDB Deferred eferred Loan Program PROPERTY: 7013 Humboldt Ave N ELECTRICAL - Furnish materials, accessories, fittings and equipment and perform work as required to place the electrical system in a complete, proper and legal operating condition. Upon completion, the electrical work in the dwelling shall be in compliance with the requirements of the FHA minimum standards, NEC and State codes. $ 1. Replace existing outlet within 6' -0" of laundry sink with GFI protected outlet. $ 2. Replace existing outlets within 6' -0" of bathroom sinks with GFI protected outlets. Specify number to be installed $ 3. Replace 2 existing outlets within 6' -0" of kitchen sink with GFI protected outlets. $ A. Furnish and install in each room 1 overhead light with wall switch in basement bedroom and pink room. $20.00 fixture allowance. • $ 5. Install 3 wall outlets each in basement bedroom and pink room. $ 6. Hardwire overhead lights and install wall switch in garage. $ 7. Install outlet for garage door opener and by workbench area. $ 8. Code electrical service. Specify all other electrical code work not listed above and the cost per work item. Bid submitted by (subcontractor /tradesperson) .SCOOE OF IMPROVEMENTS AND WORK PROPOSAL PROGRAM: CDBG Deferred Loan Program PROPERTY: 7013 Humboldt Ave N Items that homeowner said he would take care of so they would not have to be included in the loan. 1. Remove trees next to garage. 2, Repair garage window glass. 3,`! Install handrail for deck steps. 4. Hard wire work bench light in garage. 5. Install cover for storage area in garage to maintain 1 hour fire rating. I SCC tPE OF IMPROVEMENTS AND WORK PROPOSAL Alternatives and /or work not listed Itemized Cost • Homeowner Firm Name Signature • URBAN HENNEPIN COUNTY HOUSING REHABILITATION PROGRAMS FILE SUMMARY . 0 Funding: DBG Def: MHFA Def: M.-FA Rev: MHF ^AA /AccessssJ: Other: client: Address: •��,� &Q2f h61 � 7 City: Zip: 55 _ Phone: �lp App'n Recd: �� Process Begun: Completed: LLJ� # Weeks: - Eligibility Established: `0/ (date of earliest verification): Age: 1 Sex: - fil Ethnicity: 1A) Marital Status: !� _ Handicapped Household: # Residents: �� # Renters: Age of House: �( Years Resident: 1 Market Val: $ _7 ;, OD_ OO Adjusted Mkt Val = (Mkt Val x 1 10' - .) T 501 max loan: $ Mort /CD: $ Equity (or adjusted equity): $ 3626 For multiple incomes of one type enter totals below & show verifications on reverse. Income Source Monthly $ Verified Within 120 days? Salar �O s Self- Employment SS SSI r AFDC Support /Maintenace Rent Pen sion Interest Other Total monthly income: $ ?SIr Monthly expenditures: $ (List on reverse) Affordability: $ d?, Ob (if negative, within 5% of monthly income? ) Arn'1 Income: $ 00 Eligible income for h'hold in city: $ 3 Assets: $ r 1 (If,verificaticn required, list on reverse) Title Verified: Zcning Verified: . Inspected: Scope Out: Complete Bids: