COOK COUNTY ASSESSOR JOSEPH BERRIOS COOK COUNTY ASSESSOR’S OFFICE 118 NORTH CLARK STREET, CHICAGO, IL 60602 PHONE: 312.443.7550 FAX: 312.603.3352 WWW .COOKCOUNTYASSESSOR.COM CLASS L (LANDMARKS) ELIGIBILITY APPLICATION This Application must be filed before construction begins. Include drawings, surveys and two copies of the ordinance (or resolution) and supporting documentation. Applicant Information Name: _____________________________ Telephone: (_____)_______________________ Federal Employer Identification Number: __________________________________________ Address: ___________________________________________________________________ City: ______________________ State: __________ Zip Code: ______________________ Contact Person (if different than the Applicant) Name: _____________________________________________________________________ Company: __________________________ Telephone: (_____)_______________________ Address: ___________________________________________________________________ City: ______________________ State: __________ Zip Code: ______________________ Property Description (per PIN) If you are applying for more than three different PINs, please submit the additional PIN information in an attachment. Street address: (1) _________________________________________________________ Permanent Real Estate Index Number: ____________________________ (2) _________________________________________________________ Permanent Real Estate Index Number: ____________________________ (3) _________________________________________________________ Permanent Real Estate Index Number: ____________________________ 12/28/2010 American LegalNet, Inc. www.FormsWorkFlow.com City: ______________________ State: __________ Zip Code: ______________________ Township: _______________________ Current Property Class: ___________________ Split Codes: ______________________ (Please Circle) Industrial / Commercial / Non-profit/Multifamily (Please Circle) Individually Designated Landmark: Existing Class: ____________________ Yes / No Number of Dwelling Units: _________________ Attach legal description, site dimensions and square footage, and building dimensions and square footage. Property Use Attach a detailed description of the precise nature and extent of the current use and the intended use of the property, specifying, in the case of multiple uses, the relative percentages of each use. Property Location Is the property located within a municipality or area designated as a Certified Local Government as defined in the Class L Eligibility Bulletin? [ ] YES [ ] NO Proposed Rehabilitation Estimated date of construction commencement (excluding demolition, if any): ________________________________ Estimated date of construction completion: ___________________________________ Attach copies of the following: 1. 2. 3. 4. 5. Specific description of the proposed substantial rehabilitation; Current plat of survey for subject property; Floor plans or schematic drawing; Building permits, including dates of issuance; Complete description of the cost and extent of rehabilitation, including such items as contracts, itemized statements of all direct and indirect costs, contractor’s affidavits, etc. 6. Photographs of the interior and exterior of the building. 2 of 4 12/28/2010 American LegalNet, Inc. www.FormsWorkFlow.com Vacant Property If the substantial rehabilitation is proposed for a vacant building, provide the following information: 1) Has the building been vacant and unused for at least 24 continuous months prior to the date of application? [ ] YES [ ] NO 2) When and by whom was the property last occupied and used? _________________ __________________________________________________________________ Attach copies of the following: x x Sworn statements from persons having personal knowledge attesting to the fact and duration of vacancy Records, such as statements of utility companies, indicating that the property has been vacant and unused and the duration of such vacancy Rehabilitation Financing Year prior to construction: ___________________ Assessor’s building market value for above year: $__________________ 50% of that building market value: $__________________ Total amount of owner investment in rehab: $__________________ List funding sources for above amount of owner’s investment: ____________________ ______________________________________________________________________ List all other funding sources, with amounts, including grants and tax credits: ______________________________________________________________________ ______________________________________________________________________ Local Approval A certified copy of a resolution or ordinance from the municipality in which the real estate is located (or the County Board, if located in an unincorporated area) should accompany this Application. The resolution or ordinance must state (1) that the incentive is necessary for the substantial rehabilitation, (2) that it supports and consents to the granting of the incentive, and (3) that it has reviewed and accepted its Preservation Commission’s recommendation specifying the project budget and the proposed scope of work, which meets or exceeds the Standards of the U.S. Department of the Interior for Rehabilitation, Preservation, Restoration and Reconstruction of historic properties. 3 of 4 12/28/2010 American LegalNet, Inc. www.FormsWorkFlow.com A certified copy of the ordinance or resolution need not be filed with the Assessor at the time the Class L eligibility application is filed, but the ordinance or resolution must be filed with the Assessor no later than the date an assessment appeal is filed to request the class change to Class L. If the ordinance or resolution is not filed at the time the eligibility application is filed, the applicant shall instead, include the following items with the eligibility application: 1) a letter from the municipality or the County, as the case may be, confirming that a resolution or ordinance supporting the incentive has been requested, and 2) a copy of the Preservation Commission’s recommendation of the project. Post-Rehabilitation Information Information in this section must be submitted to the Assessor’s Office after rehabilitation work has been completed but before the Class L incentive may be granted. 1. Three copies of the Assessor’s Incentive Appeal Form; 2. A copy of the determination of the Preservation Commission that the project meets the standards of Substantial Rehabilitation as defined in the Class L Bulletin; 3. Photographs of the interior and exterior of the building; 4. Occupancy permit or other proof from the municipality that the building is in substantial compliance with the municipal building code; 5. Proof of rehabilitation costs including copies of building permits and contractor’s sworn statements or certificates for payment; 6. Documentation of financing, along with owner’s affidavit, in the form attached, attesting to the owner’s financial investment in the rehabilitation and all other sources of financing the project, including grants and tax credits. I, the undersigned, certify that I have read this Application and that the statements set forth in this Application and in the attachments hereto are true and correct, except as those matters stated to be on information and belief and as to such matters the undersigned certifies that he/she believes the same to be true. _________________________________ Signature of Owner(s)* _______________________________ Date _________________________________ Print Name _________________________________ Title *Note: If title to the property is held in trust or by a corporation or partnership, this Class L Eligibility Application must be signed by the beneficiary, officer or general partner. FOR ASSISTANCE IN PREPARING THIS APPLICATION, PLEASE CONTACT THE ASSESSOR’S OFFICE, SPECIFIC PROPERTIES DEPARTMENT AT (312) 603-7529. 4 of 4 12/28/2010 American LegalNet, Inc. www.FormsWorkFlow.com