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City of South Bend 045°uTgg <br /> Petition for Incentives <br /> Petition must include a$150 filing fee payable to the City Clerk's Office or online via the City's website at toss <br /> http://southbendin.gov/government/content/tax-abatement before processing Can be complete <br /> General Information Project Name 900Franklin Project Number <br /> Legal name as registered with Secretaryof Franklin Street Technology Park LLC <br /> Business structure Indiana Limited Liability Company <br /> Companywebsite 900FranklinStreet.com <br /> Proposed Project Information <br /> Proposed project address 900 Franklin Street Parent company name Five Corners LLC <br /> City,state,Zip South Bend, IN 46601 Legal owner <br /> Site acreage or acreage required 4.5 acres Is the real estate owned or to be owned <br /> square feet of facility 60,000 If leased by whom <br /> Primary Contact Information <br /> Primary company contact name Charles Hayes Title Managing Member <br /> Address of company contact 814 Marietta Street Phone 574-233-1296 <br /> City,state,zip South Bend, IN 46601 Email cshayes @telecompark.com <br /> Senior Official Information <br /> Company senior official name Charles S Hayes Title Managing Member <br /> Address of company contact(If different from Phone <br /> abovel <br /> City,State,Zip <br /> Consultant Information/Agent <br /> Hired business consultant/agent name Consultant release(Y/N) <br /> Address Local economic development partners <br /> a ravel Y N <br /> City,State,Zip Email <br /> Project Overview <br /> Brief description ofyour <br /> company,project,and why the See Attached <br /> property Is necessary for <br /> economic growth <br /> Filed in Clerk's Office <br /> EE <br /> arf,CLERK,SOUTH BEND,IN <br /> Certified Technology Park appropriate Yes <br /> Is the project in a Tax Incremental Financing River West <br /> F r w <br /> Certify that the Building Permit has not been Yes Number of residential unls created by n/a <br /> issued WNI <br /> If this is a petition for personal property tax abatement,has n/a <br /> the equipment been installed <br /> Investment Details <br /> Public Infrastructure needs(OH- Has any 504 funding been What Is the value of any equipment being purchased in what is the value of any equipment being <br /> site of project in dollars) received? Indiana for the project? purchased from out of state for the project? <br />