August 24 - September 18, 2015 - Washington, D.C.

CONNELL & SCHMIDT BUILDERS26. Historic District?820 CST SE WASHINGTON DC 20003 24(}-298-4120[]Yesi2JNoOYest;;?jNo28 Raze Entire Building?li?JYesONo29 Build1ng Condemned?DYes (;a No1 - - - - - - - - - - - - - - - --'- - - -30a PartyWall?0Yes{;2)Norofected.31 Building Vacant?(;aYesONo32 Publtc Space Vault?0Yesb2]No-Official Use OnlByOate35 Ran Method (baQ, bull f!f. by h nd, tc,) ";. '4o.:l-ort You must submit a Cel'tf!Cate of IOSUT( lCe covering tne ra operat;ol'\/cootractor- unless the ooildmg you plan to raze Is an accessory buHdtng 500square faet « less io aea and not more thart one story, wholly de! d'led from My other buil!ing on the sane or adjoining pl'elllse .2. Too CertifJCate uld: Show the holder of tile insurattoo as; Deputy C'irector. Permit Division. 1100 4th Sl SW. Washiogton, DC 20024 Include a J kitrt ad-vance notice anoellatk n clause. Include these amounts of insurance coverage: &dily Injury, 5100,000; Aggregate, 300.000; a11d Property Oamage, 100.000. State that the insui'Cll'lCe covers *Razing Operations in the DIS!Iict of Columbia· if the scope ot the insuranc& is foe' blanket co . If the insurance ts tor one specifiC ad"ress only, state that. Razing Op«abonsat-----·:------:---------38. Insurance CompanyHOWARD INSURANCE39. Asbestos in 8Utld1ng?37. Poficy or Certtficate No.Q. 1.\\o- \1.\ Sci q g-:::--- --es0No38 Expiration Date\O/t /15"----------1.------------. .;Official USee 0111yIf es ind1cate locattonI, Fee-j DaltIIICVUfUPage 2 of 5Eflc April 9, 2009

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Government of the District of ColumbiaDepartment of Consumer and Regulatory Affairs· ECEIVEnSEP 0 2 015uBY: -- -.Permit Open tlom Division1100 4th Street SWWnhlngton DC 20024Tel. (202) 442 4689Fu (202) 442 4862TO SCHEDULE INSPECTIONS PLEASE CALL (202) .U2 tll67September01, 2015Date:Capld:R1500196D.C. Historic Preservation OfficeI 100 4th Street S.W., Rm E6SOWashington, DC 20024Rt: Request for clearance of premi.ws subject to raziag operatioasAn application to raze the structure identified below, located in the District of Columbia, was filed onthis date with the Permit Operations Division. Our records do not reveal any kind of conservation holdson this property. We are hereby requesting confirmation from your office, in order to release the subjectpermit.Address:1620ESTSELOT: 0814SQUARE: 1090TYPE:VACANT: YesPlease notify our office of the satisfactory completion of your inspection of the premises, by filling outthe clearance section below and returning this form to the D.C.R.A. Permit Operations Division, 11004th Street S.W .Wa. hinl'tonn.r. 20024.This is to inform you that we researched our records concerning the structure identified above and wehave no objections to proceeding with the proposed razing of said structure.Oa :----------------- Signature: - - - - - - - - - - - - - - - - - - - - - - - - -fUme of releasing HPO Official. (print)Page 9 of 13- - - --"·- - - - - -- -·

' i f . . ; l I !I* , ., . .i j lll . I l l lllAPPLICATION FOR RAZE PERMITttll . 1Aflpll 7atl!:m can be downloaded and is fiUable except for signatur\' area. If not fdling out on computer, please typt or print legiblyin 1nk. Please provide detailed information. Write, /A (non·app!icable) (or items that do not appty. Erasing. crossing out.whiting out. or otherwise altering any entered Information will void this applicatiM. The owtu:r of recorrlnutst sign thel.tpplicatlon with an original signature.!,Applicable code sections are in the ZOQ8 DC 8uilding Code Supplement Chapter I§ 105.1.7, 10S.1.7.t 105.1.7.1,1, 105.1.7.1.1.105.1.7.1. and Sectton15SA.4b Suffix1 . Addre 5 ot Propwed WOO ,'1620 E. St00149. Erm:lilJD@connellschmidtcom820 C St SE Washington, DC 2001 240-298-4120C&S Development LLC13.EmallRyan connellschmklt.cor.1527 ESt SE Washington, OC 20( 202·550·1924Ryan Amons!;?]Raze Permit15. O&sillipttoo of&llding 1o be Razed {e.g. two story brick smglc tamily owelbr!g)TWO STORY WOOD FRAME SINGLE FAMILY16 E:.istmg Number of Slorte-r. Qf 81cgDWELLING- ----.-·---1218. Materials of Btrlding (bnck. wood . ---- ------ -·- .--19. BldQ Length (ft)39- - - - ··CONOIT!ONSt COMMENTS.11.3-·-22. 61dg Volume (cu it} (l lt W x H)20 . Bldg V\ dtn {II)20;s,a14OFFICIAL USE ONLY----.- ------- - --------------------1lm'1l /UPage 1 of 5Effilctiv\! Aptll 9, 2009

CONNEU & SCHM1DT BUILDERS820 CST SE WASHINGTON DC 20003 240.298-412026. H1storic District?[]Yes QJNo} - - - - -- - - - - - - : · - - · - · -·-·27. GFA?0Yesb?]No28 Raze Entire Building?29. Buildang Condemned?. ·-·-·-·- ---.-.i-------i---,4 .; .-- 30a Party \Nail?OYesb?]No31 Building Vacant?35. Raze Method {bal. bullooz . by hand, ete.)3l. Plumber's Namee1'f(l,)}rJort1. Yw must sul:lrtlit aCertificate ot·lnsurance oo os the we coo -vruess the bwlding you plan to raze is oo building 500square feet or le iO a-ea and notl1l'n than one S\'ofy, wh l!y detached from any other building on the 8me or adjoining premises.2. 1M Cet11ficate should: Show tl1& holder of the insuta as: Deputy Director, P&I'Olt Division, 1100 4th St SW, Washington. DC 20024. Include a 3CHlay advance I'IOiice cancellation dause. Include tflese amounts otinwrance: cover : Bodily Injury. 100.000; AgQfegate, 300.000: and Property Damage, S100,000. State that the insurance OO'J'ei'S Razing Operations itl the District of Columbia.· if the scope of the insurance is for b!ali:et coverage. If the tnsurance is for one speclfrt address only state that. "Razing Operatkm.s at36. Insurance CompanyHOWARD INSURANCE9. /llsb stos in Bul!dJng?37 , Policy or Certif1cate No.38, Exprration DateIQ'{fo- lti? OIG\ g\O 14/ts-[2]NoOfflclaf Use Only e llg (ocabon.: . . --··-· ·J.---. ---- ----tfet El'f

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* ** ocGovernment of the District of ColumbiaDepartment of Consumer and Regulatory Affairsece ven0nSEP II 2015 uBY:.Permit Operations Division1100 4th Street SWWashington DC 20024Fax (202) 442- 4862Tel. (202) 442- 4589TO SCHEDULE INSPECTIONS PLEASE CALL (202) 442 9557July 24, 2015Date:Cap ld:R1500167D.C. Historic Preservation Office1100 4th Street S.W., Rm E650Washington, DC 20024Re: Request for clearance of premises subject to razing operationsAn application to raze the structure identified below, located in the District of Columbia, was filed onthis date with the Permit Operations Division. Our records do not reveal any kind of conservation holdson this property. We are hereby requesting confirmation from your office, in order to release the subjectpermit.Address :920BLA DENSBU RG RD NELOT: 0067SQUARE: 4073TYPE:VACANT: YesPlease notify our office of the satisfactory completion of yo ur inspection of the premises, by filling outthe clearance section below and returning this form to the D.C.R.A. Permit Operations Division, II 004th Streel S.W . Wa-.hinl'ton 0 .\. . 20024.CLEARANCEThis is to inform you that we researched our records concerning the stru cture identified above and wehave no objections to proceeding with the proposed razing of said structure.Date: - - - - - - - - - -Signature: - - - - - - - - - - - - - - - - - - -Name of releasing HPO Official. (print)Page 9 of 13

o v t: r nm en -.:o r -.:n t: UJ::Hrri.'L u "'v'u" u aAPPLICATION FOR RAZE PERMITDEPART.\IENT Of CO SUMER & RIGU L TORY AFFAIRSApplication can be downloaded and is fillable except for signature area. If not filling out on computer, please type or print legiblyin ink. Please provide d et ailed information. Write N/A (non-applicable) for items that do not apply. Erasing, crossing out,whiting out, or otherwise altering any entered information will void this application. The owner of record must sign theapplication with an original signature.Applicable code sections are in the 2008 DC Building Code Supplement Chapter I§ 105.1.7, 105.1.7.1, 105.1. 7.1.1, 105.1.7.1.2,105.1. 7.2, and Section 155A.1. Address of Proposed Work1920 Bladensburg Road-------2. APPLICANT INFORMATION6. Property Owner7. Complete mailing address (include zip)Davita Healthcare Partners, Inc10. Agent/Contractor for Owner (if applicable)8. Phone Number(s)9. EmailII11. Complete mailing address (include zip)II12. Phone Number(s)22636 Davis Dr, Ste 250, Sterling,VAd 1703-709-950014. Check all that apply:IE] Raze Permit4. DESCRIPTION OF BUILDING15. Description of Building to be Razed (e.g. , two story brick single family dwelling)16. Existing Number of Stories of Bldg :ITHE SITE CURRENTLY CONTAINS A VACANT AUTO REPAIR BUILDING, CONCRETE PAVING17. Use(s) of Property (specifically indicate if any use is residential.)IIVacant Commercial Structure1125I1118. Materials of Building (brick, wood , etc.)I19. Bldg Length (ft)AND IIBrick, concrete, wood20. Bldg Width (ft)119521. Bldg Height (ft)111622. Bldg Volume (cu ft) (L x W x H)11190,000IOFFICIAL USE ONLYCONDITIONS/ COMMENTS:REV ll/11Page 1 of 5Effective April 9, 2009

l:: :.:-'-- ----SECJ!QN A.- -23. Raze Contractor's NameR Z I;P ERM IT-24. Contractor's Address (including zip code)ITBD.I ITBD26. Historic District?[]Yes No27. CFA?[]Yes No28. Raze Entire Building?IJYes No29. Building Condemned?DJYes No30a. Party Wall? E YesiJNo--- ---25. Contractor's PhoneIIITBDI33. Raze Contractor Signature34. Property Owner Signature30b. If yes, adjacent property owner signature is required.30c. Any raze permit application for a building(s) involving party walls must beinclude 2 copies of a plan that show how the party wall(s) will be protected.31. Building Vacant? YesDJNo32. Public Space Vault?IJYes[EI NoBuilding must be vacant before Raze Permit issuance.Officiall)s ByFeeOnlycDate.i33. Plumber's Name34. Plumber's License Number35. Raze Method (ball, bulldozer, by hand, etc.)jl11 BulldozerITBDI1. You must submifa Certificate of Insurance c c)yering the-·raze operation/contractor- nles{the bunding you plan to Yaze is arf accessory bUilding 500square f et-9r less in are11 ana nofmore than o e story, whol!y detach d from any other byjlding on the same or adjoining premises.2. Tbe Certificate should: . Show the holder of the insurance as: Deputy Director, Permit Division, 1100 4th St SW, Washington, DC 20024 lncl. de a 30:-.day ·advance notice cancel.latipn clause .i . Include these amounts ()f insu·rance coverage: Bodily Injury, 1 00,000; Aggregate, 300,000; and Property Damage, 100,000.I State that the insurancE:l covers "Razing Op erations in the District of Columbia," if the scope of the insurance is for'blanket coverage .li". If the insurance is for one specific address only, state thal, ' Razing Operations atITBD --36. Insurance Company-L .37. Policy or Certificate No.(address of raze operation)'.'38. Expiration DateIII39. Asbestos in Building?If yes, indicate location:[]Yes IE! NoIOfficial Use OnlyFeeBy.Date REV11/ 11Page 2 of 5Effective April 9, 2009

GOVERNMENT OF THE DISTRICT OF COLUMBIAAPPLICATION FOR RAZE PERMITINSTRUCTIONSGENERAL INFORMATION In order to raze a building , the Property Owner or Contractor must first get a Raze Permit, which starts the process of utilitydisconnections and further regulatory approvals. The Owner or Contractor must get a Raze Pe rm it, which approves the razing method and certifies that the utilities have beenproperly disconnected. Razing a building before you get a Raze Perm it is a violation of the Construction Code (DCMR 12) -- and can result in significantfines and penalties. Raze Permit fees are assessed based on information you provide ; any fee adjustment necessary after field inspection will beassessed on issuance of the Raze Pe rmit. Sidewalk deposits and/or tap bills may be required before Raze Permit issuance. Contact DDOT's Public Space ManagementAdministration at 202 442 4670 to get more information. Get the soi l erosion package for Raze Contractors from DDOE's Soil Erosion Unit, located in the Permit Center, to prepare your razeoperation plan. A plumbing supplemental permit , obtained by a plumber Registered and Licensed in the District of Columbia , is required for anywater/sewer line cap. Fees are required for abandonment of the water/sewer services in the public easement (paved road). You must pay any outstanding water bills before a Raze Permit can be issued. You are required to obtain a sign-off by any adjacent property owners when the raze involves party walls.RAZE PERMIT APPLICATION PROCESSRaze Permit1.Complete Areas 1-4 and Section A of the application and submit:a.b.c.d.Certification for Raze Permit ApplicationCurrent Certificate of Insurance - General LiabilityEnvironmental Intake Form (ElF)Photo(s) accurately depicting premises2.For residential property, DCRA staff will prepare and forward clearance letters to the Rent Administrator for review and approval.3.DCRA staff will prepare and give letters to the applicant for the Historic Preservation Review Board and/or the US Commission ofFine Arts, if applicable. The applicant must get the necessary approvals and submit them to the Permit Division.4.Payment of the Raze Permit fee is required. Fee calculation is based upon the volume of the structure in cubic feet times .02.5.DCRA staff will prepare and issue clearance letters to the applicant for these agency approvals/sign-offs:DCRA Construction InspectionDCRA Plumbing InspectionDDOE Asbestos AbatementDDOE Soil Erosion ControlDOH Vector ControlDDOT Public SpacePEPCO - Utility cut offVerizon Telephone Co- Utility cut offWashington Gas - Utility cut offWASA- Sewer/water line cutDCRA Zoning Administrator- Overlay impactson site6.The applicant is responsible for submitting clearance letters to required agencies , paying any required fees to the agencies , gettingwritten approvals, and returning the originals to DCRA.7.Before DCRA will issue a Raze Permit, the building(s) must be unoccupied . If the building is sti ll occupied, DCRA will accept andprocess the Permit Application , but will not issue the Permit until the applicant notifies the Perm it Division that the building is vacant.8.After the applicant has provided all required approved clearance letters, vacated the property, and paid any additional fees asdetermined by the field inspection , DCRA will issue a Raze Permit granting the applicant the authority to raze the structure by therazing method specified in the Application.NOTE: DCRA will not issue any Raze Permits before the end of the applicable30-day Advisory Neighborhood Commission (ANC) notification period.REV ll./ 11Page 3 of 5Effective April 9, 2009

GOVERNMENT OF THE DISTRICT OF COLUMBIACERIFICATION FORRAZE PERMIT APPLICATIONThis certifies thatI(referred to as Owner) owns the property atI(Legal Name of Property Owner)land that the person signing below has the legal authority to execute this Certification(Property Address)and to make the representations and certifications below, on behalf of the Owner:I am applying for a Raze Permit for the subject property .I understand that the Raze Permi t must be issued prior to any raze activity or operations .If I do not have a Raze Permit before I start any activity or operations to raze the structure, I will be subject to criminal or civilpenalties unde r District of Columbia laws.(In itial here to ce rtify that you have read an d understa nd this paragrap hA. Use ofProQert as Housing AccommodationI hereby certify that the structure to be razedIa housing accommodation .l isIS ISnoIf the structure is a housing accommodation, comQ!ete Section B. If the structure is not a housing accommodation, skip to Section C and the signature block.B. Additional Provisions AQQiicable to Razing of " Housing Accommodations"I agree, in accordance with DC Official Code (DCOC) §§ 42-3506.02(a)-(b) and 14 DCMR § 4400.2, not to use the permits to:Demolish any housing accommodation or rental unit for the purpose of constructing or expanding a hotel , motel , inn , orother transient residential accommodation .Con struct or expand a hotel , motel , inn , or other transient residential occupancy on the site of a housing accommodationor rental unit demolished after July 17, 1985.(Initial here t o certify that you have rea d an d understand t his paragraptI acknowledge that I must comply with the requirements in the "Tenants Opportunity to Purchase Act," codified in DCOC § 423404.02 , et seq., and in subchapter VII of the "Rental Housing Act, " cod ified in DCOC §§ 42-3507 .01 to 42-3507 .03 withimplementing regul ations in 14 DCMR § 4401 . T hese requirements include, but are not limited to:Providing tenants with an opportunity to purchase the housing accommodation, via a written copy of an offer for sale,before issuing a Notice to Vacate for purposes of demolition or discontinuance of housing use.Provid ing tenants with a 180-day Notice to Vacate that complies with and notifies each tenant of his/her potential right torelocation assistance.(I nitial here t o certify t hat you have read and understand this paragraplC. Execution and Certification AQQiicable to All AQQiicantsI certify that I have read and understand the requirements in this certification and that any representations I made here are trueand accurate to the best of my knowledge. If I fail to follow the above requirements , I acknowledge that this application, and anypermits issued as a result of it, may be revoked under DCRA's authority and discretion. I acknowledge that I have been advisedth at fai lure to get a Raze Permit before I start operations to raze the structure may subject me to criminal and/or civil penalties.Name of Owner: IISignature:ISignature:(Print Name of Owner)Name of Agent:I{Pnnt l'ilame of Jl:utnonzea Jl:ge ntjREVPage 4 of 5l.1/l.l.Effective April 9, 2009

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Government of the District of Columbia" A Tai Department of Consumer and Regulatory Affairs·· - - - -

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