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55B - RESO BRISTOL ST PROJ PHASE 4
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55B - RESO BRISTOL ST PROJ PHASE 4
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5/3/2016 2:25:56 PM
Creation date
5/3/2016 2:20:49 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
55B
Date
5/3/2016
Destruction Year
2021
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jProperty Description cont'd <br />23. Appliances/ other items in dwelling (list items by ownership): <br />23. Aparatos electrodomeaficoa u otroa aparatoa en la vivienda (ponerloa en orden de posest6n): <br />Tenant: <br />Inguilino: <br />Owner: _ <br />Propietarto: <br />24. How many separate structures are on the property that people are living in? <br />24. Cuantm eab-uctaraa separadm Rene la propiedad y gue eatan siendo hahitadas? <br />Renters Information <br />Waarvlea n iianoruao°Oiiown : ff du,,llndacee un aalko Die Ijjwoll era y manager, Ilalleaw wdk a puaes9uowa 11)..55 on (page 5 <br />25. Do you have a lease? Yes❑ No❑ a. When does the lease end? <br />25. Tiene un conn-ato de renta? a. Cuanto se final La el conn-ato 9 <br />b. Whose name is on the lease? <br />h. A nomhre de guien esta el eonPwto de yenta? <br />26. Name of the individual primarily responsible for paying the rent: <br />26 Nomhre de la persona gue se encarga de pagan la renta? <br />27. Name of other individuals, family members, or heads of household who contribute to the rent: <br />27. Nomhre de miemhroa de familia, jefe de familia u otras persona gue eonb-ihuyen al pago de la renta: <br />28. Monthly Rent: $ 29. What utilities are included in your rent: Gas❑ Electricity❑ Water❑ <br />28. Menmalidad 29. Que utiilidades est m ineluidads en la yenta? <br />a. Deposit amount:$ a. What do you pay for utilities that are not included in your rent: $ <br />a. Canfidad de dep6sito I a. Cuanto pago por Im utiilidades gue no estan ineluidm en su renta? <br />30. Does anyone in the household receive a rent subsidy: Yes❑ No❑ <br />30. Alguna persona en el hogar recihe aaistencia para la vivienda? <br />a. What type of rent subsidy? Section 8 voucher❑ Other: <br />a. Que claw de aaistencia para la vivienda recihe? Secci6n 8 u otra? <br />b. Are you, or anyone in your household related to the owner of the property or property manager? Yes❑ No❑ <br />h. Usted o alguien en su familia esta relacionado con el dueho de la propiedad o el manejador? <br />If so, what is the relationship ?: <br />St es asf, cual es su relaei6n? <br />Owner /Occu ant Information <br />31. Is there a mortgage on the home ?: Yes❑ No❑ a. If so, how much is the monthly payment: $ <br />31. Tiene usted ma hipoteca o prestamo sobre su hogar? a. Cuanto es la mensmlidad de su hipoteca o prestamo? <br />b. Mortgage origination date: c. Current balance: $ d. Interest rate: % <br />h. Fecha en gue se origino su hipoteca o preatamo? c. Balance o cantiidad gue dehe: d. T= de interea: <br />e. Type of loan: Fixed❑ Variable❑ VA/VET❑ FHA❑ Other: f. # of payments left:_ <br />e. Tipo de preatamo: Fijo Paiiahle 017,0 f. Canfidad de pagoa restantes <br />Initials of Respondent (iniciales del entrevistado): Initials of Interviewer:_ <br />Page 3 of 8, Residential Survey /Interview 55B -56 rev.09 115 <br />
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