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City of South Bend Instructions:Complete pages 1-3 i f*to <br />AND the proper Form SB-1 for <br />a <br />Petition for Incentives the type ofabatement(real <br />property or personal property) 4 .1u <br />Petition must include a$250 filing fee payable to the for which you are applying. <br />City of South Bend"before processing can be complete <br />General Information Project Name Project Number <br />Legal name as registered with <br />Secretary of State Cross Community, Inc <br />Business structure CDC-Domestic Nonprofit Corporation <br />Company website https./Imycrosscommunity.org <br />Proposed Project Information <br />Proposed project address 1728 Harrison Ave <br />Pa rent company name <br />City,state,Bp South Bend, IN 46616 <br />Legal owner Cross Community, Inc <br />Site acreage or acreage required 0.1212 <br />Is the real estate owned Ownedorleased? <br />Square feet of facility n/a if leased,by whom? <br />Primary Contact Information <br />Primary company Contact name Tina Patton <br />Tide President <br />Address of company contact 707 Sherman Ave <br />Phone 574-876-2106 <br />City,State,p South Bend, IN 46616 <br />Email <br />Senior Official Information <br />Company senior official name <br />Title <br />Same as above <br />Address of company contact Phone <br />If different from above) <br />City,State,Zip <br />Email <br />Consultant Information/Agent <br />Hired business consultant/agent name <br />Consultant release?(Y/N) <br />Address <br />Local economic development partners <br />approval?(Y/N) <br />City.State.Zap <br />Email <br />Project Overview <br />Brief description of your <br />company,project,and why the We will build one (1) new home that will be between 1390-1620 sq ft <br />property Ls necessary for with 3 bedrooms, 2 bathrooms, with a garage. <br />economic growth <br />Certified Technology Part appropriate VA <br />lithe project in a Tax incremental Financing <br />River WestUM)area?Hsi,which? <br />Have Building Permits been issued?(Y/N) Number of residential unitscrented by , <br />Note Nat eligible for abatement HYc) N PfO)c <br />If this is a petition for personal property taw abatement,has . <br />Atheequipmentbeeninstalled? <br />Investment Details <br />Public btfrastructrue needs Has any 504 funding been What is the value at wry equipment being purchased In What Is the value of any equipment being <br />Off-site of project in dollars)received? Indiana for the project? purchased from out at state for the protect? <br />I Filed in Clerk Office <br />MAY 0 8 2024 <br />Bianca Tir;icj , <br />City Clerk, South Caul Id, IN