HomeMy WebLinkAboutCAG2021-227 - Other - Robert & Sally Mendel - Disclosure Statement & Buyer's Acknowledgment - 05/20/2021ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
Director or Designee Mayor
Date of Council Approval:
Grant? Yes No
Type:Review/Signatures/RoutingDate Received by City Attorney:
Comments:
Date Routed to the Mayor’s Office:
Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms.
(Print on pink or cherry colored paper)
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 20210219
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
Dana Ralph 05/20/2021
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Exhibit C — DISCLOSURE STATEMENT
Sally and Robert Mendel
10028 SE 267 Street
Kent, WA 98030
3. Sewer/On-Site Sewage System
Last pumped: 05-29-2018 (Jamie's Septic Service)
Last inspected: 05-29-2018 during pump
F. Have there been any changes or repairs to the on -site sewage system?
09-08-2008 Replaced sewer line, inlet baffle and clean out
4. Structural
C. Have there been any conversions, additions or remodeling
Master bathroom - remodel
Basement — finished
E. Has there been any settling, slippage or sliding of the property or its improvements?
Yes, used Slab Jack for the back patio in 2015