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Oregon Department o( Transportation
<br />~"` ~ Relocation
<br />REPLACEMENT HOUSING WORKSHEET
<br />Relocatees' Names: ____~c~ r,c-~ ~~ e~~ ~, ~-o k,~~~ File Number
<br />Rent Supplement~j Down Payment ^ Housing Additive ~ Market Rent ~ Site only for MH ~ No Land, only MH ^
<br />/~
<br /> SUBJECT COMPAR. #1 COMPAR. #2 COMPAR. #3
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<br />Heat ~ ` _
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<br />'; Total Mo. utility cost - 7S
<br />' Total housing cost
<br />~ (rent + utilities)
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<br />Non-refundable Fees
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<br />Information on the average monthly utility costs was verified from ~(~a F'_
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<br />Comparable #~s
<br />_ was selected because:
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<br />Form 103 (6/95) Pa9e ~ of 4 RELOCATION
<br />REPLACEMENT HOUSING WORKSHEET
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