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'9T <br />This statement is4eeing completed far rasiP <br />prq arty -that qualMes.under the fogow[M Indian* <br />I I <br />1O.Radevelopmer'l ortababIblitIon of real estate improvernents (ICS-1.1-12.1-4): <br />ar" (10 B-1,9 1 2.14.1) <br />"P(b; k b A - <br />9 0010ir2ofi w M - apnb <br />ar; Ewhon9c Asi0itizationAm <br />lnTo <br />miilipa A iopipp�t f.7 mik* Its deals - 466t whatheitp de A00 <br />ft <br />*011M 88-1 i Real Property <br />P NO <br />Any Informal lan,cm.ceffft the =0 <br />OW patftsS►Arm <br />261J011=1 11-41 .416"sk by om <br />0111owner istomerawpar <br />21-6.1. - <br />x4bollo to. t4e#98jork" body voowihe iV4104f6pmaht. arrehii6p6aft pf milprqp6iV for which the parsoo wishes to crawm -a doomw. <br />7haafvhweAto1benbRts Rum 6,vaikv obmffled.lb. the d1aiW0gbo*snd#marea, designated an amiornk, iwfilwlcrier'ea D664 Me ►*krn of <br />the ra4'evefcintentiou *NO tl*p MMdeskes to clam a dld621. <br />To Ablaut • avduqW. a #bfin'32ikE Must be Ned 01h the couplykiditarbabrb May 164, the y6ov hi which Me adcftv to assessed vald0on is <br />M" 1h#!y!jfV "Ib d h- 6 '",ad 6-the PM p*16. Ap(q]pa0&#&*ho <br />ds�vAftr a assiq" q.ce.z.., �-90 olok� Al, W- 8"s mWlid- AhrA <br />failed fiiffle 0 didud1pn a <br />,pplfcagdn; i df 6:suo <br />defidbil- -jmk'ffb sh appIkadon betwean hfart6 i. 4id* . 10! <br />May <br />'yownerWhofts"Ibriba kc '-r' d -OWIho WMCF;14Wa Prop <br />A;'AprvPWi* -db I ffbnmusto.�oM the "'difored �skoiiifihqbp ,Thd FoO6 GF-1AUN <br />'d for �iprtbe'dadudlq <br />0. <br />Property <br />Nowid,be ' aflachbd to' the Foram P& 000 nis appacsiNe. <br />10 M; -1;!t' If �P) <br />a Form m 19, 9; IlReaj -Aqpwfy that is . <br />approved MW jamo.30, 201A. the dssVtm#q Is'Mqubm0a "fabils)l `6r oath; <br />9 body <br />dedp0b& adowid. - Aor a jFprpi SS.-YAReal Pm*ythaf. Is approved prior to July 1, 20.13,, the sbibirriient ached6li approved by ihe dehign4firig hO� <br />mmins in effect:' ljo64.1-11.1-17 <br />,Paged oft <br />- <br />SECTION111 TAXPAYER <br />INFORMATION <br />me of <br />?he ,L064rtmith Company, Inc. <br />Aq dRR -qf Wm Or P=# N!r M!q d- A 07X Ats k - If'VP ondo <br />40N.Te6hinIolo' gy Drive. Sol 6th Band ' IN 4 L WS <br />i;jaMeLfMMW, POW A <br />Thfaptwne,noinbpr <br />6-majkddress <br />I -Milksihdditi <br />074 ),259-7000 <br />marl .s1nCWr01obBrMuth.coni <br />I SECTION 2 LOCATION AND DESCRIPTION <br />• PROPOSED PROJECT <br />—6fi- h0 y <br />Resolution number <br />City of-SbL4b Bend, City Cqt4nd <br />Lomm of piopoty <br />9kWAY <br />DLQF Wind dist0d number <br />4004 Tedbnology Drive, South Bend, IN 465628 <br />ST JOSEPH <br />069- <br />EsOmeted 0M dMe (roonth, 4Y Year) <br />BdIdIjn9*iffipr**0eqls ift additional 1;000 sf'16 house automated CDndordla <br />pto.duict fine <br />Maly 1 S, 2418 <br />WmMed oompWbn date.(frigrifft dPy year) <br />be66'mb6r $1, 2016 <br />SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES <br />AS RESULT OF PROPOSED PPCJECT <br />Currant number Ist"ea NUM bet felaMcd <br />aglarle <br />I <br />>40..00 70.00 <br />-0 ; 16 640.0 5.06 0 $208,000:00 <br />SECTION 4 ESTINIATEDTOTAL COST AND <br />VALUE OF PROPOSED PROJECT <br />REAL ESTATE IMPROAMENTS7 <br />COST Asstsm VALUE <br />curnilrltyllilv'u <br />Me estimated values pfow t <br />posed p�o*q <br />273,000-00 <br />Less-values of' p - being replaced <br />E4 <br />_Tpady <br />Not estimated values upon 6flmpistlon of Jett <br />22AND.00 <br />SECTIQN 5 WASTE CCtJVERTFD AND OTHER <br />BENEFITS PROMISED BY THE TAXPAYER <br />Estimated solid waste oonveded (pounds) <br />EstItneled hmrdous w Is% Cfj"'I" <br />[APR 2 0 2016 <br />KAREEMAH FOWLER <br />[_CITY CLERK, SOUTH BEND, IN <br />SECTION 6 TAXPAYER CERTIFICA7FION <br />1 tieieby r�rtffylliattFie raprpsentafions in this statement are. true, <br />DOW forredlimW 30 OW 4 <br />Pfinled obine of SUIhofted reprasenWM <br />,Paged oft <br />- <br />