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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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Income Information <br />34. Primary and secondary sources of household income: Employment (full time) ❑ (part time) ❑ <br />34. Fuente de ingresos pimaiios y secundarios: Empleo (tiiemo completo) (media tiiempo) <br />Retirement pension❑ Social Security❑ Public assistance (welfare) ❑ Unemployment❑ Food stamps❑ <br />Pension de rettro Segura Social Asigtenciapuhlica Desempleo Egtampillae de comida <br />SSI❑ Workers Comp. ❑ Child support ❑ Other family subsidy (including alimony)❑ <br />Segura Social Suplemental Compeneaci6n del trahajador Sostenimiento al niho Ob-og guhgidio familiar (incluyendo agigtencia de divorcio) <br />Other: <br />Otero: <br />35. Combined monthly income of household BEFORE taxes: Under $5000 $500 -$999❑ $1,000 - $1,499❑ <br />35. Ingresos comhinados menauales ANTES de impuestog: <br />$1,500- $1,999❑ $2,000 - $2,499❑ $2,500- $2,999❑ $3,000- $3,499❑ $3,500- $3,999❑ $4,000 +0 <br />36. Do you get rental income from this property? Yes❑ No❑ <br />36 Ohnene usted algun ingreso de renta de su propiedad/viviendcO <br />Trans ortation & Education <br />37. Distance to household member's place of work: Head of household: (_Miles) C— Minutes) <br />37. Distaneia de su hogar a su lugar de trah4o: .1efe de familia millag minutos <br />Other member of household: <br />Obvg miemhros de su hogar: <br />(_Miles) ( Minutes) <br />(_Miles) ( Minutes) <br />(_Miles) ( Minutes) <br />38. The three principal means of transportation used by your household members, indicate order most used (1,2, <br />etc.) <br />38. Los b-eg medios de b ansporte principal usado por log miemhros de familia, indigue el orden de ago mks fi-ecuente. 1 giendo el mks usado. <br />Bicycle_ Bus_ Car_ Metro_ Ride with others_ Walk_ (# of cars in household)_ <br />Bicicleta Autohug Cantu Pageo con on,og Caminar Cantiidad de autos en la familia <br />39. K -12 Schools attended: <br />39. Escuela de kinder a secundarta que anende: <br />40. Primary transportation to and from school(s): Bicycle L3 Bas❑ Car❑ Metro❑ Ride with others❑ Walk❑ <br />40. Transporte principal gue usa hacia y de regreso de su escuela(s): <br />41. College attended:_ <br />41. Universidad o eolegios gue <br />42. Primary transportation to and from college: Bicycle❑ Bas❑ Car❑ Metro❑ Ride with others [3 Walk❑ <br />42. Transporte pincipal gue usa hacia y de regrego de la Universidad o colegio: <br />Initials of Respondent (iniciales del entrevistado): Initials of Interviewer. <br />Page 5 of 8, Residential Survey/lnterview 55B -58 rev.09 115 <br />
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