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STATEMENT OF BENEFITS
<br />REAL ESTATE IMPROVEMENTS $ 10 2o_ PAY 20
<br />State Form $1767 (P.211 -07) y ^ 2
<br />Pr ®scribed by the Department of Local Government Finance t� t' Rai SS -1 1 Real Property
<br />This statement is being Completed for real property that qualifies under the fotioM Inds a o0.irbis �
<br />❑ Redevelopment or rehabilitation of real estate impmvemeants (IC 6.1.1 - 12.1 -4)
<br />© E1 191ble vacant building (IC 6- i.f- 12.t -a.8) CIVCL-
<br />INSTRUCTIONS.
<br />1. This statement must be submitted to the is d designating the Economic RevRarmation Area prior to the publlchearfny lithe desrgnatrng body requires
<br />rrlformation from the applicant in making its decision about whether to designate an Economic Revitallzadon Area,
<br />Otherwise if the this statement must i be
<br />submitted to the designating 6adyBEl =pRl= the radevefapmerrt ar rah ahrlitaiion of rea! ro
<br />'Pi4ects' planned or committed to after July 1, 1987, and areas designated alter July , 1987,requirera STATEMENT OF BFJVEFIT5. (IC 6 -1-1,1 -12.1)
<br />APProval ofthe deslgnadnp body (City Council Town Board, County Council, etc,) must be obtained prior to initiation ofMe redevelopment orrehabillteflon,
<br />BEFORE a deduction may be approved.
<br />3. To obtain a deduction, application Form 322 ERA/RE or Form 322 ERAIVBD, Whichever is applicable, must be Sled urith the County Auditor by the later
<br />Of (1) May 10,• or (2) thirty (30) days after the notice of addition to assessed valustlon
<br />shown on the records ofthe township assessor. or new assessment's mailed to the property owner at the address
<br />4. Property owners whose Statement of Benefits wee approved after June 30 1991, must attach a Form CF- 1/Real Properly annually to the application to
<br />show compliance with the Statement of Benefits. (lC t3 -7.1- 127- 6.i(bJ end 1C 6- 1. i- 121 - 5.3(!)1
<br />5. The schedres established under IC 6.1.1 - 12,7-4(4) forrehabillteted property and under IC ti -1.1- 12.1. 4.8(1) for vacant buildings appy is any statement
<br />ofbeneiPts approved on orafterJuty 1, 2400. The schedules effecblre
<br />July f, 2000. Pr�r July ?, 2040, she!! continue to apply to a statement of benefits Sled before
<br />Name of taxpayer
<br />dtaxW,yw(numbwendsfnsat W sloth, and ZlApode)
<br />1 Mendota Heights Road St.PaUl MN 5,5120
<br />canlad person
<br />.. Tel6phone number
<br />City of South Send
<br />Location at pmPedY
<br />�417055 G€eve€and Road, South Bend, IN 46628 Joseph
<br />Deecrtpt3on of n3alprvpertyP vvemenlM redeveioprnent or rehabilrtation fuse add ffortarsheeta ifneoessary}
<br />Mechanical and Electrical upgrades to support the operations and equipment of
<br />the Distribution Center for medical, dental, and veterinary supplies; plus
<br />10,000 SP of new office and supporting spaces
<br />AAAYA'AAAld1 _.
<br />60 $27, 040 avg. NumbWreftlned
<br />pez person 1 60
<br />NOTE: Pursuant to IC 6-1A- 12,1 -5.1 (d) (2) the COST of the property
<br />Is coMtdentlal.
<br />Current values
<br />Plus estimated values of prooised project
<br />Less values of any RM2q being replaced
<br />Net estimated values upon eamPletion of orofed
<br />Estimated solid waste converted (pounds) N/A
<br />Other benefits
<br />I hereby certify that the representations in this statement are true.
<br />'ride
<br />$27,040 avg.] Number a,
<br />Per person
<br />001=1fox e
<br />REAL ESTATE
<br />COST
<br />$6,700,000
<br />$2,500,000
<br />D
<br />$9,200,000
<br />E -mail address
<br />seen- auniz6Detteraondeatel.ctra
<br />Resolution number
<br />DLGF tracing diairiet number
<br />EdkG9ted start data (month, day,
<br />11010tod complaWn date (rnanth, deY 300
<br />10/01/2010
<br />tonal so Sa>~ , 800 avg.
<br />P� Person
<br />ro0,
<br />,avv,
<br />Estimated hazardous waste converted (Pounds) N/A
<br />Page 1 of 2
<br />Date slpaed (mon85, day, year]
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