5.2. SR 07-22-2002Item 5.2.
City
MEMORANDUM
TO:
FROM:
DATE:
Mayor and Council
Lori Johnson, Finance Director
July 22, 2002
SUBJECT: Consider Lease Agreement Between City of Elk River and
Harvest Evangelism, dba, Love Elk River
The Council recently approved leasing the house at Woodland Trails Park to Love Elk River
as transitional housing. City Attorney Charlie Wilson has drafted a lease for the property,
which is attached for your review.
The lease requires payment from Love Elk River in the amount of $300 per month plus
direct payment of all utilities. Love Elk River will be subleasing the house to those in need of
transitional housing. All the conditions of the lease between the City of Elk River and Love
Elk River transfer to the individual(s) living in the house.
Action Requested
The City Council is asked to approve the attached lease between the City of Elk River and
Harvest Evangelism, dba Love Elk River.
S/Council/Lori/LeaseHarvest
City
TO:
FROM:
DATE:
SUBJECT:
MEMORANDUM
Mayor and Council
Tina Allard, Executive Secretary
July 22, 2002
Consider Lease Agreement Between City of Elk River and
Harvest Evangelism, dba, Love Elk River
The lease agreement was not received in time for the packet mailing. It will be handed out at
Monday night's meeting.
WOODLAND TRAILS HOUSE LEASE
It is agreed this 1't day of ,2002 by and between The City of Elk River,
Landlord, and Harvest Evangelism Inc. d/b/a Love Elk River, collectively, Tenant:
That the Landlord hereby leases to the Tenant, and the Tenant hereby leases from the
Landlord, the house located in Woodland Trials Park, , Elk River MN 55330, the
rented area shall include the approximately 200 ft by 250 ft yard bounded by the park entrance, the
golf course, the county road, and the garage, the unattached garage is included in the rented area
(the "Premises"). Tenant shall not have access to the separate storage area in the garage which will
be used by Landlord which reserves the right to lock the storage area and access it on a regular basis
without prior notice to the Tenant.
In consideration of the mutual promises of the parties herein and upon the terms,
provisions, and conditions following:
1. LEASE TERM.
The term of this Lease shall be one (1) year commencing on the 1't day of ,
2002, to and including the 31't day of , 2003. If not terminated at the end of the
initial lease term as hereinafter provided, this Lease shall automatically renew for successive one-
year terms. If either party wishes to terminate the Lease at the end of the inifal lease term or
thereafter, written notice must be given 30 days prior to the end of the Lease term.
2. RENT.
Tenant shall pay as rent for the Premises the sum of Three Hundred dollars ($300.00) each
month due on the first day of each month beginning on 1, 2002, said rental shall be
paid at all times in advance for the month, with interest on all delinquent rental at the maximum
lawful rate allowed under the law of Minnesota from date due, and all sums shall be payable to the
Landlord at 13065 Orono Parkway, Elk River, MN, 55330. In the event Tenant has not paid the
monthly rent by the fifteenth day of the month an additional late fee of $25.00 shall be due.
Landlord shall have the fight to increase the amount of monthly rent at the beginning of
each renewal term by giving Tenant written notice of the increased rent at least 60 days prior to the
end of the then current Lease term.
3. USE.
Tenant shall use the Premises to provide transitional or emergency housing only and shall
not permit the Premises to be occupied for any purposes or permit any act which shall invalidate
any policy of insurance on the Premises or increase the fire hazard. Tenant shall not permit any
pets or other animals to be kept on the premises. Tenant further agrees not to permit any activities
that would interfere with the public's use or enjoyment of the neighboring park.
Woodland Trails I-~ouse Lease
I, 2002
4. CARE OF PREMISES.
Tenant shall use due care to maintain the Premises in good condition and shall surrender
possession of the Premises to Landlord at the expiration of this Lease in as good repair and
condition as the same are now, or may hereafter be placed. (Ordinary wear and tear, non-negligent
damage by fire, or the elements excepted). Without limiting the foregoing, Tenant shall (a) comply
with all obligations primarily imposed upon tenants by applicable provisions of building and
housing codes materially affecting health and safety; (b) keep that part of the Premises that the
Tenant occupies and uses as clean and safe as the condition of the Premises permit; (c) dispose
from the Premises all ashes, rubbish, garbage, and other waste in a clean and safe manner; (d) keep
all plumbing fixtures in the Premises as clean as their condition permits; (e) use in a reasonable
manner all electrical, plumbing, sanitary, heating, ventilating, air conditioning and other facilities and
appliances in the Premises; (f) not deliberately or negligently destroy, deface, damage, impair or
remove a part of the Premises or knowingly permit a person to do so; (g) act in a manner that will
not disturb a neighbor's peaceful enjoyment of their Premises. Tenant shall not make any
alterations, additions, improvements or structural alterations to the Premises without Landlord's
prior written consent, which consent may be granted or withheld in Landlord's sole discretitn.
5. ASSIGNMENT AND SUBLETTING.
Tenant shall not assign the Lease without the prior written consent of Landlord, which
consent may be granted or withheld in Landlord's sole discretion.
Tenant may sublet the Premises or a portion thereof for the purposes set forth in Section 3
of this Lease. Tenant must require that all Subtenants agree to the rights of Landlord, terms and
Restrictions set forth in this Lease and Tenant must indemnify, defend, and hold harmless Landlord
from the claims of any subtenant. For the purposes of this Lease "Subtenant" shall mean any
person occupying or using the premises under any type of agreement with Tenant. Tenant shall
have all Subtenants sign an agreement substantially in the form of Exhibit A.
6. UTILITIES.
Tenant shall pay for all utilities including, but not limited to telephone, water, electric and
garbage fees .
7. RIGHT TO ENTER.
Tenant shall allow Landlord, its agents or workmen, at reasonable times, at Landlord's
discretion, to enter the Premises to inspect the same, make repairs or improvements, or show the
Premises to persons desirous of leasing same. Landlord shall have the right to enter upon and into
the Premises to meet any apparent emergency.
8. NO ORAL CHANGES.
No statement, representation, or promise with reference to this Lease or the Premises, or
any repairs, alterations, or improvements, or the change in the term of this Lease shall be binding
upon either of the parties unless in writing and signed by both Landlord and Tenant.
2
Woodland Trails House Lease
I, 2OO2
9. DEFAULT.
If Tenant fails to comply with the terms of this Lease, Landlord may pursue all remedies
available to Landlord under Minnesota law.
a. Examples of defaults by Tenant include the following:
(1) Tenant vacates the Premises without giving Landlord the required notice;
(2) Tenant fails to pay the rent when due;
(3) Tenant fails to pay utility charges when due;
(4)
Landlord gives Tenant the required notice to vacate and Tenant fails or
refuses to move out by the time specified by Landlord in the notice;
Tenant fails to maintain or repair the Premises in the manner stated in this
Lease;
(6) T~nant permits pets or other animals to be kept on the Premises;
(7)
Tenant creates a clear and present danger to others as described in
paragraph 11 below.
(8)
Tenant permits or fails to prevent conduct by Subtenants in violation of this
Lease.
b. Examples of remedies available to Landlord if Tenant defaults include the followingx
(1)
If Tenant fails to pay the rent or other amounts when due, Landlord may,
upon three days' prior written notice to Tenant, terminate this Lease;
(2)
If Tenant fails to maintain the Premises pursuant to the provisions of this
Lease, Landlord may terminate this Lease upon ten days' prior written notice
to Tenant. Said nofce shall specify the acts or omissions of Tenant which
constitute the default and, if remedied by Tenant within said ten-day period,
the Lease shall continue. If Landlord is required to give notice of default for
Tenant's failure to maintain the Premises more than once within any six-
month period, Landlord shall have the fight to terminate the Lease by giving
Tenant ten days' prior written notice of termination.
If Tenant fails to comply with the provisions of paragraph 11 of this Lease
with regard to the health and safety of others, Landlord may terminate this
Lease upon three days' written notice of termination to Tenant.
Co
In the event Landlord terminates this Lease due to a default by Tenant, Landlord
may bring a court action to:
Woodland Trails House Lease
I, 2002
(1) Require Tenant to vacate the Premises; and/or
(2) Recover any unpaid rent or other amounts owed by Tenant; and/or
(3)
Recover actual damages suffered by Landlord as a result of Tenant's default,
including reasonable attorneys' fees.
10. DELAY OF POSSESSION.
If Landlord is unable to give Tenant possession at the beginning of the term, the rent shall
be rebated on a pro rata basis until possession can be given, which rebated rent shall be accepted by
Tenant as full settlement of all damages occasioned by said delay and if possession cannot be
delivered at the beginning of said term, Tenant may, upon at least five days written notice to
Landlord, terminate the Lease and upon termination, Landlord shall return all prepaid rent and
security deposit to Tenant.
11. RESTRICTIONS.
Tenant shall not: (a) obstruct the halls or stairways, shall only use the same for passage to
and from Premises; (b) cover or obstruct any windows that admit light into halls or passageways; (c)
make or permit any disturbing noise in the building by themselves, their agents, or guests; (d) do or
permit anything by such persons that will interfere with the rights, comforts or convenience of
other Tenants, guests or the public; (e) shall not create or maintain a threat constituting a clear and
present danger to the health and safety of other Tenants, the Landlord, the Landlord's employees,
or other persons within 1,000 feet of the Premises. A clear and present danger to the health and
safety of others includes, but is not limited to:
a. Physical assault or the threat of physical assault;
Illegal use of a firearm or other weapon, the threat to use a firearm or other
weapon illegally, or the possession of an illegal firearm; and
Co
Possession of a controlled substance other than prescription medication which was
obtained directly from or pursuant to a valid prescription.
Tenant and Tenant's agents, employees and guests shall obey all rules and regulations as the
Landlord shall from time to time establish.
12. WAIVER OF CLAIMS BY TENANT.
Except as prohibited by Minnesota law, Tenant agrees to make no claim, and hereby
expressly waives any and all claims against Landlord for or on account of any personal injury
sustained or any loss or damage to property caused by fire, water deluge, overflow, or explosion,
however arising or caused, or being within the Premises, and further waives any claim for any loss
of any articles by theft or from any other cause from the Premises.
Woodland Trails House Lease
I, 2002
13. INSURANCE.
Tenant agrees to carry General public liability insurance against claims for bodily
iniury, death or property damage occurring on, in or about the Leased Premises and the
adjoining streets, sidewalks and passageways, with limits of not less than $500,000.00 with
respect to bodily injury or death to any one person, not less than $500,000.00 with respect
to injury or death to more than one person in any one accident, and not less than $500,000
with respect to property damage. Tenant further agrees to carry a policy insuring personal
property to be used, stored or otherwise present on the Premises. Landlord will not be
liable for damages as expressed in Paragraph 12 "Waiver of Claims by Tenant."
14. FIRE OR CASUALTY DAMAGE
If the Premises are damaged or destroyed by fire or casualty to an extent that enjoyment of
the office is substantially impaired, Tenant may (a) immediately vacate the Premises and notify
Landlord in writing within 14 days of Tenant's intention to terminate the Lease, in which case the
Lease shall terminate as of the date of vacating; or (b) if continued occupancy is lawful, vacate a part
of the Premises rendered unusable by the fire or casualty, in which case Tenant's liability for rent is
reduced in proportion to the diminution and the fair rental value of the Premises. If the Lease is
not terminated by Tenant, as provided herein, the building cannot reasonably be repaired within
thirty days from the date of such damage, and if Landlord elects not to repair such damage, the
Lease shall cease and become null and void effective as of the date of the damage.
15.. AUTOMOBILES.
Landlord shall not be liable for damages to any automobile, motorcycle, or any recreational
vehicle owned by Tenant caused by the negligence of any other tenant or any other person while
said vehicle is parked anywhere on the Landlord's property.
16. NOTICE.
All notices to be given by Tenant to Landlord shall be by personal delivery to Landlord at
the address below or by sending the notice by certified mail, return receipt requested. Said notice
shall be deemed to be given upon receipt by Landlord.
All notices to be given by Landlord to Tenant shall by personal delivery to Tenant at the
Premises or by sending the notice by certified mail, return receipt requested to Tenant at the
address below or such other address as the Tenant may designate. Said notice shall be deemed to
be delivered upon the date of personal delivery or upon the date postmarked by the U.S. Postal
Service.
City of Elk River
13065 Orono Parkway
Box 490
Elk River, MN 55330
Love Elk River
810 South 7m Street Nehemiah Center
Woodland Trails House Lease
I, 2002
Minneapolis, MN 55415
CITY OF ELK RIVER
HARVEST EVANGELISM INC.
D/B/A LOVE ELK PaVER (Tenant)
By:
(Tenant)
GP:902005 vl
6
Hastil gs Housing Coalition
PO Box 714
Hastings, Minnesota 55033
Rental Agreement
In reliance upon thc statements made in thc Transitional l-lousing In-Take and Participant Phm
Forms. which arc integral parts of this Rental Agreement, thc Lessor, Hastings Housing Coalition,
hereby leases to .Lcsscc (s), thc premises locatcd at
This prolx:rty shall bc leased on ;: month to month basis ~ginning thc first day of
.20~. Thc maximum term for this transitional housing lease is 24 months.
Lcsscc understands that his/her monthly :'cllt obligation shall not cxcccd thc grcatcr of 30% of thc
[kmulv's monthly a~iustcd income. 10% of thc lkm~ily's monthly income, or any part oFwclfarc paymcnts
receiVe'cd l¥om a'public agency by thc [umily st~cifically designated by thc agency for housing costs. In no
event, however, tllay thc rent charged cxcccd thc el<rating cost of thc pro~y. In,this instance, r~nt
shall ~ in thc amount of $ .~r month, as calculated at thc date of occupancy, bascd on
Lcsscc's current household income. In thc instance of a change in household income, Lcsscc is
rcslmnsiblc for rc[m:'ting such change (increase or decrease) within 30 days to thc Lessor so that an
appropriate a{justmcnt in thc amount of rcm duc can ~ made. Rent is duc on thc first day of each
calendar month to thc Lessor and should ~ mailcd to thc llastings Housing Coalition, PO Box 714,
Hastings, MN 55033 in one lump sum.
If Lcsscc ~comcs eligible for subsidized housing then Lcsscc shall make reasonable efforts to
obtain alternate housing. Failure to do so may result in thc termination of thc lease.
135' thc mutual agreement of thc parties, this Rental Agreement is subject to thc following terms
and conditions:
1. SECURITY DEPOSITi Prior to occupancy, Lcsscc shall make a security deposit of one month's rcm
as calculated at thc timc oF occupancy or $ . This dclX}sit shall bc retained by thc
Lcssor during thc term of thc Rental Agrccmcat as a bond for thc satisfactor).' performance of thc terms of
this Agreement on thc part of thc Lessee. Thc deposit shall bc refunded to thc Lcsscc shortly alicr thc
premises arc vacated when the Lessor or its agents have had a reasonable opportunity, but not in excess of
2 1 days, to ascertain It;Il compliance with the terms of thc ^grccmcnt by thc Lessee, and providing Lessee
has inForn~cd Lessor o£ hia/hcr l'or'~varding address and returned all thc kc.','s.
If any portion of thc security deposit is not rcfundcd. Lcssor shall, within 21 days, give written
masons to thc Lcsscc why thc dclx}sit was withheld. Lcsscc's liability For damages or breach of this
Agreement is not limited by thc amount o£ thc security d¢tx)sit. Thc security d¢l:>osit shall not bc applied
g. L.'~WS AND REGULATIONS. Lcsscc ~grccs to comply with all laws, ordinanccs and rcgulations
at)plic:~blc to thc l)rcmiscs and facilitics or thc usc thcrcof. Lcs$cc agrccs to notify cascworkcr
in'mlcdi;.acly if thc Policc or Shcriff is callcd to thc rcsidcncc.
9. NUISANCE. If thc Lcsscc, llis/hcr guests, or :lnyonc undcr his/hcr control becomcs into.xicatcd,
disordcrly, or crcatcs or tx:traits any unncccssary noisc, nuisance, or othcr disturbancc on thc prcmiscs,
thc I_.cssor shall havc thc option, ii' said co~ditioas continuc, of tcrminating thc Lcsscc's right to
posscssion pursuant to t~aragrapl'l 17 (c).
10. CONTROLLED SUBSTANCES. Lcsscc agrccs to kccp tim propcrty 1¥cc from thc illegal usc.
possession or distribution of controllcd substanccs. Evidcncc of usc, posscssion, or distributioa of
controllcd substanccs on thc prcmiscs will bc grounds for cviction.( Sec Lcasc Addcndum 2)
11. BUILDING RULES. Lcsscc ag,'ccs to comply with arb' rcasonablc talcs anti rcgulations rclating to
thc usc of tlic prcmiscs, now or thcrcaftcr ix~blishcd by Lcssor includir~g kccping thc housc, yard and
garagc frcc £rom ar~y auto or motorcyclc cnginc$, kccping thc housc, yard and garagc [rcc from anything
that could start a tim. cxplodc or t:x)isoa lx:oplc or animals with a limit of a total of tllrcc gallons of
gasolinc on thc prOlX:rty. Lcsscc also agrccs to kccp thc housc, yard, and garage fmc from any fircarms.
12. I"L~T,5.. Lcsscc will llcithcr kccp nor lpcrmit pc. ts oil thc prcmiscs.
13. WATER-FILLED FURNITURE. No watcrbcds nor any othcr watcr fillcd l'urniture will bc uscd on
thc prcmiscs.
14. t/,IZNTI~R'S 1NSURANCIS. Lcsscc must providc proof of adcquatc rcntcr's insurancc within 30 days
of moving in. Lcssor is not rcs[xmsiblc for damagc/dcstruction to lcsscc's bclongings.
t5. ~Lcsscc mav not scll or assign this Agrccmcnt nor sublct thc prcmiscs nor ;.my part
thcrcof withoul, first obtairfing thc 'writtcr~ conscnt of thc Lcssor. Givcr~ tllc purposc of this propcrty, and
thc waitin§ list for its usc. it is unlikcly that such conscnt will bc givcn.
16. AUTI-IORIT¥. Lcsscc undcrstands th;.lt thc Lcssor's right to Icasc this prol:'~rty is subjcct to the
continuation of Lcssor's owncrship of thc housing unit.
17. L/\TE PAYMENT. Rcnt is duc on thc first day ofcacli montll, and it is Lcsscc's rcslxmsibility to
insurc that paymcnt in full is tcndcrcd to th.c I-lastings l-lousing Coalition. A "gracct, riod" of five (5)
days is :.~llowcd, but on thc sixtll day of each n',or~tll, a sc:w'icc charge of $1.00 tx:r da), shall accrue.
without cxccption for Sunday's or holidays, up to a maximum of $15.00 until all rcr~t duc is paid in full.
Rctuni of a Lcsscc's chcck for any mason shall be trcatcd as non-paymcra of rcnt for all purlx~scs tmdcr
this Agrccmcnt.
18. I.,ESSOIC,'5 RIGI-tT OF ENTRY. (:0 For M;.fintcnancc. Lcssor rcscn,cs thc right to cater thc
prcmiscs ;.it any time without notice for thc purlx~sc o1' makir~g cmcrgcncy rcpairs or implcmcnling
cmcrgcncy mcasurcs to protect or prcscrvc thc building and its l~.xturc$. If such ;.m cnt~.'y occurs, l_,cssor
shall promptly notil}' Lcsscc of thc datc. timc. and purposc of such cato~ arid thc cmcrgcacy which
required it. Lessor may also enter thc premises at any reasonable time and upon reasonable prior notice to
Lcsscc to inspcct For and to accomplish ncccssa~.~~ prcvcntivc maintenance. Lcsscc understands that
Lessor will make pre-arranged, pcriodic inspections oF thc unit to determine that thc premises and
furnishings arc being propcrty maintained and to provide appropriate maintenance as required.
(b) For Displ~y Lessee shall permit Lessor to show thc premises to prospective residents at any
time between 9 a.m. and 8 p.m. without additional notice within 30 days prior to thc termination of this
Agreement, however, as a courtesy to thc Lessee, Lessor shall attempt to contact thc Lessee to arrang, c a
mutually agreeable time to bring prospcctivc residents to vic:,,' thc premises in order to minimize thc
disturbance of thc tenants priva~.
(c) For Breach. This Agreement is made ut~n thc cxprcss conchtion that if thc rent shall not bc
paid when duc, or if thc Lcsscc shall at any time fail to perform any of thcsc conditions, or shall abandon
thc premises, then thc Lcssor may terminate thc Lesscc's right to possession immediately and without
prior notice. If lessee has not moved out voluntarily, lessor may bring an eviction action. Upon eviction,
lessor can retake possession of thc apartmcnt without giving up any right to require Icsscc to pa.')' rent for
thc remaining period of thc lcasc.
19. ATTORNEY"S FEES. Lessee shall reimburse Lessor for all attorney's fees and consist, permitted by
law, incurrcd irt any unlawful detained action iii which thc Lessor prevails, or any legal action
commenced to collect any rc~lt arrears, sc~.'icc charges or damages.
20. CANCELLATION NOTICE. The term of this lease shall Ix: month to month, and either part), shall
bc entitled to terminate this lease upoa thirry (30) days written notice to the other party stating that party's
intent to cancel this lease.
21. NO OTI-tER REPRESENTATIONS. Any modificatioll of this Agreement shall be made only iii a
writing signed by all panics to this Agreement at thc time oi' thc agreement (or any lease Addcndum's
made and attached). Lcsscc hereby acknowledges that Lessor has made no promises, expressed or
implied, except those contained in thc Agreement or attached hereto in conformaacc with the preceding
scntcncc or provided for by st,'~tutc. Thc covcnants and conditions herein contained shall bind the heirs,
legal representatives, and assigns of thc parties hereto, and all covenants arc to be construed as conditions
of this Agrccmcnt.
22. DEFAULT. If any default is made in payment of rent, or if any dcfimlt is made in thc performance of
or compliance with any other term or conditions hereof, this Agreement, at thc option of Lessor, may be
tcrnfinatcd.
23. ACCEPTANCE AS WAIVER. Lcssor's receipt of rent with knowledge of any breach, is not deemed
to bca waivcr as to any broach of any covcnam or condition herein contained.
24. I-lOUSING MANAGER. Thc Hastings ]qousing Coalition is authorizcd to manage thc premises and
accept sca:icc of process and give receipts for notices and dcmands.
TRANSITIONAL HOUSING
LEASE ADDENDUM Two (2)
FOR A DRUG-FREE/CRIME-FREE HOUSING
Address of Property:
In consideration of thc execution or renewal of a lcasco f thc dwcll ing unit identified in thc lease, Owner
and Resident agree as follows:
I. Resident, any members of thc rcsidcnt's household or a guest or other person under thc rcsidcnt's
control shall not engage in criminal activity, including drag-related crmfinal activity, on or near thc said
prcmiscs. "Drug-rclatcd criminal actMtv" means thc illegal manufacture, sale, distribution, usc or
possession with intent to manu£acturc, sell, distribute, or usc of a controlled substance ( as defined in
Section 102 o£thc Controlled Substance Act 121 U.S.C.802] ).
2. Resident, any member of the rcsidcnt's houschold or a guest or other person under thc rcsidcnt's
control shall not engage itl any act inlcndcd to facilitate criminal activity, including drug-related criminal
activity, on or near thc said prcmiscs.
3. Resident or mcmbcrs of thc household will not .rx:nnit thc dwclling unit lo be used lbr or to facilitate
criminal activitg, including drug-related, criminal activity, regardless or whether thc individual engaging
in such activity is a member of thc household, or a guest.
4. Resident or members of thc household will not engage in the manufacture, sale, or distribution of
illegal drugs at ~ locations, whether on or near thc dwclling unit premises or otherwise.
5. Resident, any mcmbcr of thc rcsidcnt's household, or a guest or othcr pcrson under thc rcsidcnt's
control shall not engage in acts ofviolcnc¢ or threats ofviolcnc¢, including but not limited to thc unlawful
discharge of firearms, on or near the dwelling unit premises.
6~ VIOLATION OF THE ABOVE PROVISIONS SHALL BE A MATERIAL AND IRREPARABLE
VIOLATIONS OF THE LEASE AND GOOD CAUSE FOR TERMINATION OF TENANCY. A single
violation of any of thc provisions of this added addendum shall bc deemed a serious violation and a
material and irreparable non-compliance with thc lease. It is understood and agrccd that a single
violation shall be good cause for termination of'thc lease. Unless otherwise provided by law, proof of
violation shall not require criminal conviction, but shall bc by a preponderance of thc evidence.
7. In case of' conflict bctwccn thc provision of this addendum and any other provision of thc lease, thc
provision of thc addendum shall govern.
Lcasc Addendum li Pagc 2
8. This LEASE ADDENDUM is incortx)ralcd into thc lcasc cxccutcd or rcncwcd this day bciwccn Owncr
and Resident
Rcsidcnt
Daic:
Housing/Lcasing Coordinator
Daic:
HOUSE MOVE---IN OUT--INSPECTION FORM FOR ~
DATE: HHC MEMBER FAMILY
KITCHEN:
Electricity. (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Stove (Broiler Pan)
Microwave
Refrigerator (Racks Y or N/Bras Y or N)
Sink
Plumbing
Moisture
Food storage/prep area (counter tops)
Cabinetry.
Door
LIVING ROOM:
Electricity (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Door
BATHROOM:
Electricity (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Indications of moisture
Conditions of tub/shower
Conditions of sink
Condition of toilet
Door
BEDROOM (1)
Electricity (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Closet condition
Door
ItALLWAY
Electricity (bulbs/fixtures)
Electrical Hazards
Ceiling condition
Wall condition
Floor condition
Linen closet condition
HOU'SE MOVE---IN OUT--INSPECTION FORM FOR 713 WEST 18TM STREET
DATE:
BEDROOM (2)
Electrici .ty (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Closet condition
Door
BEDROOM (3)
Electricity. (bulbs/fixtures)
Ele.~'acal Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Closet condition
Door
FAMILY ROOM:
Stairway condition
Electrici .ty (bulbs/fixtures)
Electrical Hazards
Ceiling condition
WaU-~ondition
Floor condition
Closet condition
Door condition
HHC MEMBER
FAMILY
BATHROOM:
Electricity (bulbs/fixtures)
Electrical Hazards
Ceiling condition
Wall condition
Floor condition
Indications of moisture
Conditions of sink
Condition of toilet
Door
FURANCE ROOM:
Electricity (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Furnace/AC condition
Cabinetry
Door
BEDROOM (3)
Electricity (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
HOUSE MOVE---IN OUT ,INSPECTION FORM FOR 713 WEST 18TM STREET
DATE: HHC MEMBER FAMILY
Closet condition
Door
LAUNDRY ROOM:
Electricity (bulbs/fixtures)
Electrical Hazards
Window condition (Glass/Screens)
Window blinds/shades
Ceiling condition
Wall condition
Floor condition
Dryer condition
Washer condition
Sink condition
Indication of moisture
Freezer condition
GARAGE:
Electricity (bulbs/fixtures)
Electrical Hazards
Ceiling condition
Wall condition
Floor condition
Door condition
Entry. door condition
Items left in garage
Lawnmower condition
FURNISHING IN UNIT WHEN
FAMILY MOVES IN:
FIRE EXTINGUISHERS IN DATE
SMOKE ALARMS TESTED
Y ORN