CM-2017-1328 - 2/24/2017DocuSign Envelope ID: 796C5A67-AF9D-430B-B43F-E4F3946436F4
DocuSign Envelope ID: 076755DB-9965.4C37-BODt-43SCOEFBC623
Frons gO1Y•R•1�
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CLMM FOR PAYMN'T OF RENT SUFFL]EMENT
Laurie Hadley
City Manager
1. Ta:
PamiNo,;17 County: Willk=a
1LOW CSJ: Q683•t]1.09E 1;'t;o cct No..
2 NamaoiClttunant
4. Replaccanrntllhusing Addmi r.
JamiSbxunSmltb
3R2Madow0dclir.,llotI%TX 18634
3. Property Ac�ulmd by 5tat-
Hy. I...J Negotiation Condarandou
Apt Nos 5ita,lo:
Addms: 3002 Glenwood St, Round Ruck, TX 79MI
Apt. No,: SftcNu.:
R. Dau Clainsant Movtd into Rtpirsaxumt Hs aft
7KzntcsX 14.2017
5. Typo orOccupunry Cnvmod byl liin Claim:
❑ Ownrx•Occupant 0 Ttrsont
9. Amount of Viii Claim 530,0%36
Nans0 ® lfousc
Apurunent ❑ Aptutmcnt
t Total Reat Supplanutt $30.09636
❑Mobiluliomc ❑ Mobslclinnsc
lasmltment(Ist,2nd,3rd,urfittal) T
❑ sIceplagRoom
b. Total Last Rant Punbtssa Paytnrnt 5
6. Connulf Mo. Dery Yr.
4Due9
is Pim Ofro In NgrA- Wi I 1 U D9 20315
1. Arnuunt Paid tet Principal S
b. Data 1n Mays
7. Continuous O=upeacy of Propaty Acqulraf by Stgtc:
1, inetdtatal Pspmm S
From (Date):Mny20s3 TotlTtucorMuve);Stsn.ld,2D17
,,� �;; !((}},(•� ,yrs �>. 511;;?
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., ti � ,,'lh•••c,:a 1 .: ..l'.%� �'t
10. Pa)wcm or this claim in the amount shown in Dloek9 aWvc is "urstaL i eetify dent tbh rome ens nude as a rrattb or tht acquWtion of the property
for Id¢hxssy pus wm' deo inrunwamr submitted herewitb G Due wW cmro:4 and That 1be dws4lfog 1 tuw occupy tach Ow taadardr of do:cw, sato rued
eanitwyImusingtodtcbcttofmykowrledoandbelef.
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sassuuv7.9lit7 -
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tDamorlrupection
Impoctcdl]y-SiAxw=
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I ecrtify tlut I haw Nominal dtie claim Ind fmuxl It to emJmas to der arplkaltla laps and tcgidrttiaos govemtug selocadsrcr ns7lssaoco paysnrm.I Amba
certify tbeeompuhtian of tbapaytncat sM Lha iaftnswlims sbo"betria Licorn �bmmtoscd rarpgmmi4
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Mir. By. EMAM
It1dM aFWrry St+pavutr
Laurie Hadley
City Manager
DocuSign Envelope ID: 076755D8-9965-4C37-BDD1-43BCOEF9C623
Tkras
of
Form ROW-R-107(Rev 10/10)
Page 1 W4
SUPPLEMENTAL PAYMENT ESTIMATE - REPLACEMENT HOUSING
_
Print or
a All Information
Displacee's Name:
Jami Shaun Smith
ROW CSJ: 0683-01-092
Project No.:
Parcel No.: 17
Highway No.: RM 620
Unit or Bldg, No.:
First Offer in Neptiations (Date): 10/32016
Occupancy Since (Date):
May 2015
County: Williamson
Type Supplement:
❑ Normal
❑ Revised
® Last Resort
❑ 180 -day Owner
® 90 -day Occupant
❑ Late Occupants
Property From Which Displaced:
® Single Family Home ❑ Mobile Home Site
❑ Apartment ❑ Other:
❑ Mobile }-tome
❑ Duplex
❑ Utilities in Subject Rent 0 Utilities Not in Subject Rent
Monthly Gross income:
53.044.73 X 30% _ $913.42
Replacement Property Data
• Denotes Selected R lacementpreptny
Property Total
No. Rooms
Apprx. Sq
No. lldr Ft A .e Quality Cond. Yd. lmv. Index
Probable
Sales Price I Rental Cost
Subject 6
3 1397 l 7
2 3 13
$1,250.00
10* 7
3 1480 2 16
3 3 24
-� $1,395.00
11 7
3 1467 5 16
3 3 27
$1,495.00
12 8
3 1777 4 19
3 3 29
$1,625.00
Replacement housing Supplement
Replacement Cost S
Subject Value $
Supplement $
Rent Su
plement
Actual Rent
$1,460.00
x _42
$61,320.00
Fair Market Rent
$
x 42
S
n _
Gross Income
$913.42
x42
$38,363.64
Replacement Cost Supplement
$1630.00
x 42
$68,460.00
Supplement = $30,046.36
DocuSign Envelope ID: 076755D8-9965-4C37-BDD1-43BCOEF9C623
Form ROW -R-107
(Rev 10110)
Page 2 oro
Total number of displaced persons: 2.
List name, age, gender and relationship of household occupants other than displacee(s) named on page I.
Michelle — 26 - Partner
REMARKS:
'rhe subject property is a rental property in which Ms. Smith and Partner live. Ms. Smith's partner Michelle is a student and
does not contribute to the household, she does not work.
The entire tract is currently being used for residential purposes and is improved with a 1397 square foot single story single
Family residence. The residence was constructed in 1966 and contains a living room, dining room, kitchen, 3 bedrooms,
bathroom. Ms. Smith has stated that she wants to stay as close as possible to the current area because of her job,
Ms. Smith and 1 discussed her income and she does qualify as low income and a copy of check stub is attached to this packet.
Ads. Smith provided her last pay stub of the year -12/10/2016 thru 12/23/2016 including an additional work week to add to her
year, per ROW Supervisors instructions.
Year to Date Income
$35,906.70
+ I week (35 hrs. Q $18.00 hr. -
$630.00
Gross Income
Annual Income
$36,536.70
$913.42
Monthly Income
$3,044.73
x__ 42..-
X 30 0/a
$913.42
$38,363.64
Selected Comp # 10•
Replacement Cost Supplement
51630.00
x 42
$68,460.00
Supplement = S30,096.36
1 searched the area for comps near the subject property. The displacee has requested to remain in close proximity to that of
the subject due to Iter job. Comparable 910 is most comparable which consists of three (3) bedrooms, 2 baths, kitchen, living
room, dining room and a utility room which is considered functionally equivalent to that of the subject.
Method ofSearch: Intemet, local newspaper and neighborhood searches.
H.W. Lochner lncJs requesting approval for this Replacement Housing Supplement in the amount of $30,096.36 under Last
Resort Housing.
The supplemental payment(s) on page I have been determined by me and are to be used in connection with a federal -aid
highway project. The replacement housing used for these supplement computations are certified to be fair housing open to all
persons regardless of race, color, religion, age, sex, national origin or handicap and consistent with the requirements of Title
VII] of the Civil Rights Act of 1968. 1 have no direct nor indirect, present or contemplated interest in this transaction nor will
1 derive any benefit from the supplemental payment.
DocuSign Envelope ID: 076755DB-9965-4C37-BDD1-43BCOEF9C623
Form ROW -R-107
(Rev. 10118)
Page 3 oto
Prepared by: Recommended Approval:
•'7r
Right of Way Agent Data Project Manager Date
Division Use �nl
Reviewed by:
ROW Division Reviewer
Date
Approved by:
Division Director
Date
The supplemental payment(s) on page 1 have been determined by me and are to be used in connection with a federal -aid
highway project. The replacement housing used for these supplement computations are certified to be fair housing open to all
persons regardless of race, color, religion, age, sex, national origin or handicap and consistent with the requirements of Title
VIII of the Civil Rights Act of I968. I have no direct nor indirect, present or contemplated interest in this transaction nor will
I derive any benefit from the supplemental payment
Prepared by:
(signature) Date
�Lauc-ti M, j(�c
(print name)
Right of Way Agent
Recommended Approval:
(si afore)
(print name)
TxDOT Right of Way Project Manager
Approval by:
La
ocuSigned by:
vJ (�aVI�'atu
DDDEBEMEJ-14M
(sig )Harrah
(print name)
Project Delivery Supervisor/Manager
_ z1bII Iq
[late
2/8/2017
Date
DocuSign Envelope ID: 076755D8-9965-4C37-BDD1-43BCOEF9C623
REPLACEMENT — HOUSING COMPARISON GRID
PROJECT: RM - 620
PARCEL: 17
DISPLACEE(S): Jami Shaun Smith
SUBJECT COMPARABLE COMPARABLE COMPARABLE
PROPERTY # 10 # 11 # 12
ADDRESS
1002 Glenwood St.
601 Hill Brook
2321 Sycamore
8315 Glen Canyon
Round Rock, TX
Drive
Round Rock, TX
Dr.
78681
Round Rock, TX
78664
Round Rock, TX
78681
78681
SALES / RENT PRICE
$1,250.00
$1,395.00
$1,495.00
$1,625.00
SQUARE FOOTAGE
1397 sq, ft.
1480 sq. fl.
1467 sq. f1.
1777 sq. fl.
TOTAL # ROOMS
6
7
7
8
TOTAL BEDROOMS
3
3
3
3
TOTAL BATHS
1
2
2
2
CONDITION
Fair
Good
Good
Good
LOT SIZE
0.290 acres
0.27 acres
0.16 acres
0.13 acres
AGE (YEARS)
1966 = 50 yrs. old
1980 = 36 yrs. old
1992 — 24 yrs. old
1990 = 26 yrs. old
TYPE DWELLING
Single Family Home
Single Family Home
Single Family Home
Single Family
Home
GARAGE
2 Car -Detached
2 Car -Attached
2 Car -Attached
2 Car -Attached
HEATING / AC
Window Unit AC
Central
Central
Central
Central Heat
TYPE CONSTRUCTION
Wood Frame/Wood
Wood Frame/ Stone
Wood Frame/ Brick
Wood Frame /
Siding
Ext.
Ext.
Brick Ext.
BUILT-IN APPLIANCES
No
Dishwasher,
Dishwasher,
Dishwasher,
Disposal
Disposal
Disposal
APPURTENANCES
3 bedroom, I bath,
3 bedroom, 2 bath,
3 bedroom, 2 bath,
3 bedroom, 2 bath,
dining room, living
kitchen, dining
kitchen, dining rm.,
kitchen, 2 dining
room, 2 car detached
rm.,living rm.,
living rm,
rm., 2 Living rm.,
garage with laundry,
laundry nn. in 2 car
laundry/pantry area,
2 car attached
back patio
attached garage,
2 car attached
garage and
Fenced back yard
garage, Fenced back
laundry room
ard.
DocuSign Envelope ID: 076755D8-9965-4C37-BDD1-43BCOEF9C623
Forth ROW -R-109
(Rev. 07111)
Page 1 of 2
RESIDENTIAL PROPERTY EVALUATION
Property No.:Subject
Print or Type All Information - Attaeb Photographs to Reverse Side
Owner or Listing Agency:
Penny and Tina Lacke
ROW CSI: 0683-01-092
Project No.:
Address of Property (Street, City, Apt. No. or Bldg. No.:
1002 Glenwood Street, Round Rock, TX 78681
County: Williamson
® Single Family Home Apartment ❑ Sleeping Room
❑ Mobile Home ❑ Mobile Home Site ❑ Other - Explain in Remarks
❑ Utilities In Rent ❑ Utilities Not in Rent
Date Inspected: 6/20/2016
Listed Sale Price: S
Probable Sales Price:
Listed Rental Cost: S
Age (Years): 50 yrs. old
Total Rooms: 6
Approx. Sq. Ft.: 1397
Number of Bedrooms: 3
Number of Baths. 2
Lot Size: 0.290 acres
Type Garage: 2 car -Detached
Type Heating: Central
Type Air Conditioning: Window Units
Type Construction: Wood Frame/Wood
Siding
'Type Utilities: Electric, water, gas
Type Street: Asphalt
Quality: Fair
Condition: Fair
Yard Improvements: Good
Built-in Appliances:
® None ❑ Cook Stove ❑ Oven ❑ Dishwasher ❑ Disposal ❑ Other -Explain in Remarks
Remarks:
This home is in fair condition.
comlvparison Index
Age
1
Quality
7
Condition
2
Yard Improvements
3
Index
13
DocuSign Envelope ID: 076755D8-9965-4C37-BDD1-43BCOEF9C623
CSJ: 0683.01-092
Project: RM 620
Parcel:
Relocatee:
Address:
Phone No.:
Cell No.:
Residential Relocation Initial Interview
Owner/Tenant
Round Rock TX 78681
12- rl 9fS--q
Sn rn to __
IF RELOCATEE IS TENANT PLEASE ANSWER THE FOLLOWING:
Current Rent $ 12150 per Month Plus: Water Gas ZElect. Other
Furnished Unfurnished Furnished Kitchen Appliances
Landlord:
Address:
Phone Nur
Are any rent supplement paid to you or fort ygu by any welfare organization or other organizations?
Yes No 7
If so, how much and by whom
Other welfare Aid to dependant children
Food Stamps
Pension Retirement
Total Income for all sources:
Date of Occupancy: _ mQ.l �� Number in Dwelling: Z
School District:
Elementary:
Jr. High:
Sr. High:
Place(s) of Employment:
Distance No. of Age Sex Grade
Children
Distance Salary
DocuSign Envelope ID: 076755D8-9965-4C37-BDD1-43BCOEF9C623
How do you get to work? h }f TAr T_
Other pertinent social institutions, community facilities and distances to each:
IF RELOCATEE IS OWNEP, PLEASE ANSWER THE FOLLOWING:
Approximate balance owed on property:
Monthly payment:
Interest Rate on Note:
Do monthly payments include taxes and insurance? Yes
Note payable to:
Address:
) , S,�
Wk
Displacee Signature
Displacee Printed Name
_1.(it,� o r ZA _
Relocation Agent
No
Date: 1 D 1 i- I r LQ
Date: /D /I/ 46
City of Round Rock
ROUND ROCK
TEXAS Agenda Item Summary
1
Agenda Number:
Title: Consider approval of a Claim for Payment of Rent Supplement -
Replacement Housing Form for the RM 620 ROW Project, Parcel 17 -
tenant Jami Smith.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 2/24/2017
Dept Director: Gary Hudder
Cost: $30,096.36
Indexes: RR Transportation and Economic Development Corporation (Type B)
Attachments: 00372886.PDF, 00372850.PDF
Department: Transportation Department
Text of Legislative File CM -2017-1328
Consider approval of a Claim for Payment of Rent Supplement - Replacement Housing
Form for the RM 620 ROW Project, Parcel 17- tenant Jami Smith.
The claimants are tenants being displaced from the residence located 1002 Glenwood
St. which is being acquired in connection with the RM620 improvement project. As part
of the required relocation process the City's consultant recommended the amount of
$30,096.36 for rental supplement compensation according to the guidelines of the
TxDoT ROW Manual and the Uniform Act, and this amount was reviewed and
approved by TxDoT staff. The landowners are now requesting payment of the full
qualified amount of $30,096.36 for a rental supplement. The supplement amount is
100% reimburseable by TxDoT under the interlocal agreement.
Cost: $30,096.36
Source of Funds: RM 620 ROW
City of Round Rock Page 1 Printed on 2/2312017