This record contains private information, which has been redacted from public viewing.
Record #: SO2013-2476   
Type: Ordinance Status: Passed
Intro date: 4/10/2013 Current Controlling Legislative Body: Committee on Zoning, Landmarks and Building Standards
Final action: 2/5/2014
Title: Zoning Reclassification Map No. 1-G at 500-536 N Milwaukee Ave, 806-834 W Grand Ave, 500-522 N Green St and 501-517 N Green St - App No. 17705
Sponsors: Misc. Transmittal
Topic: ZONING RECLASSIFICATIONS - Map No. 1-G
Attachments: 1. O2013-2476.pdf, 2. SO2013-2476.pdf
ORDINANCE
 
 
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
 
 
SECTION 1. Title 17, ofthe Municipal Code of Chicago, the Chicago Zoning Ordinance be amended by changing all the Residential Business Planned Development No. 1027 symbols and indications as shown on Map No. 1 -G in the area bounded by
 
beginning at North Milwaukee Avenue; North Halsted Street; West Grand Avenue; a line 324.19 feet west ofthe intersection of North Milwaukee Avenue and West Grand Avenue as measured along the north right-of-way line of west Grand Avenue and perpendicular thereto; a line 40.29 feet north of and parallel to West Grand Avenue; the alley next east of and parallel to North Peoria Street; a line 171.82 feet north of and parallel to West Grand Avenue; a point 171.82 feet north of West Grand Avenue and 135.48 feet east of North Peoria Street; and a line from a point 171.82 feet north of West Grand Avenue and 135.48 feet east of North Peoria Street; to a point, 398.82 feet northwest of the intersection of North Milwaukee Avenue and West Grand Avenue as measured along the southwesterly right-of-way line of North Milwaukee Avenue and perpendicular thereto (ToB),
 
 
to those of Residential Business Planned Development Number 1027, as amended which is hereby established in the area above described, subject to such use and bulk regulations as are set forth in this Plan of Development herewith attached and made a part and to no others.
 
 
SECTION 2. This ordinance shall be in force and effect from and after its passage and due publication.
 
FINAL FOR PUBLICATION
 
 
 
 
ORDINANCE
 
 
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CHICAGO:
 
 
SECTION 1. Title 17, of the Municipal Code of Chicago, the Chicago Zoning Ordinance be amended by changing all the Residential Business Planned Development No. 1027 symbols and indications as shown on Map No. 1-G in the area bounded by
 
beginning at North Milwaukee Avenue; North Halsted Street; West Grand Avenue; a line 324.19 feet west of the intersection of North Milwaukee Avenue and West Grand Avenue as measured along the north right-of-way line of west Grand Avenue and perpendicular thereto; a line 40.29 feet north of and parallel to West Grand Avenue; the alley next east of and parallel to North Peoria Street; a line 171.82 feet north of and parallel to West Grand Avenue; a point 171.82 feet north of West Grand Avenue and 135.48 feet east of North Peoria Street; and a line from a point 171.82 feet north of West Grand Avenue and 135.48 feet east of North Peoria Street: to a point, 398.82 feet northwest of the intersection of North Milwaukee Avenue and West Grand Avenue as measured along the southwesterly right-of-way line of North Milwaukee Avenue and perpendicular thereto (ToB),
 
 
to those of Residential Business Planned Development Number 1027, as amended which is hereby established in the area above described, subject to such use and bulk regulations as are set forth in this Plan of Development herewith attached and made a part and to no others.
 
 
SECTION 2. This ordinance shall be in force and effect from and after its passage and due publication.
 
FINAL FOR PUBLICATION
 
 
RESIDENTIAL BUSINESS PLANNED DEVELOPMENT NO. 1027, as amended
PLAN OF DEVELOPMENT
 
STATEMENTS
  1. The area delineated herein as Residential Business Planned Development No. 1027, as amended, consists of approximately 42,019.46 square feet (0.96 acre).
  2. All applicable official reviews, approvals or permits are required to be obtained by the Applicant or its successors, assignees, or grantees. Any dedication or vacation of streets or alleys, or easements, or adjustments of right-of-way, or consolidation or resubdivision of parcels, shall require a separate submittal on behalf of the Applicant or its successors, assignees, or grantees and approval by the City Council.
  3. The requirements, obligations and conditions contained within this Planned Development shall be binding upon the Applicant, its successors and assigns and, if different than the Applicant, the legal title holder and any ground lessors. All rights granted hereunder to the Applicant shall inure to the benefit of the Applicant's successors and assigns and if different than the Applicant, then to the owners of record title to all of the Property and any ground lessors. Furthermore, pursuant to the requirements of Section 17-8-0400 of the Chicago Zoning Ordinance, the Property, at the time any applications for amendments, modifications or changes (administrative, legislative or otherwise) to this
 
 
APPLICANT:      URBAN FORM INVESTMENTS, LLC
ADDRESS:      500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN STREET, 501-517 NORTH GREEN STREET
DATE INTRODUCED:      APRIL 10, 2013
CHICAGO PLAN COMMISSION: JANUARY 16, 2014
1
 
 
FINAL FOR PUBLICATION
 
Planned Development are made shall be under single ownership or under single designated control. Single designated control for purposes of this paragraph shall mean that any application to the City for any amendment to this Planned Development or any other modification or change thereto (administrative, legislative or otherwise) shall be made or authorized by all the owners of the Property and any ground lessors. An agreement among property owners, the board of directors or any property owners association, or a covenant binding property owners, may designate the authorized party for any future amendment, modification or change.
 
 
4.       This Plan of Development consists of these sixteen (16) Statements; a Bulk Regulations and Data Table; an Existing Zoning Map; an Existing Land Use Map; a Planned Development Boundary and Property Line Map; a Site Plan; a Landscape Plan; a Green Roof Plan; and Building Elevations (South, Northeast, West, East from Green Street, and West from Green Street), dated January 16, 2014, prepared by Pappageorge Haymes, Ltd. Architects. Full-size sets of the Site Plan, Landscape Plan and Building Elevations are on file with the Department of Planning and Development. The Planned Development is applicable to the area delineated hereto and these and no other zoning controls shall apply. In any instance where a provision of the Planned Development conflicts with the Chicago Building Code, the Building Code shall control.
 
 
 
 
APPLICANT:      URBAN FORM INVESTMENTS, LLC
ADDRESS:      500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN STREET, 501-517 NORTH GREEN STREET
DATE INTRODUCED:      APRIL 10, 2013
CHICAGO PLAN COMMISSION: JANUARY 16, 2014
 
2
 
 
FINAL FOR PUBLICATION
 
5.      The following uses shall be permitted within the area delineated herein as "Residential Business Planned Development": All uses permitted in the B2-5 Neighborhood Mixed-Use District, except those in the Group Living Use Category; Drive-Through uses as long as reviewed and approved through Site Plan Approval and approved by the Chicago Department of Transportation ("CDOT"), Fire Department and Mayor's Office for Persons with Disabilities ("MOPD"); accessory parking and related uses.
 
 
6.       Identification signs shall be permitted within the Planned Development subject to the
review and approval of the Department of Planning and Development. Temporary signs, such as construction and marketing signs shall be permitted, subject to the review and approval ofthe Department of Planning and Development.
 
 
7.       Off-street parking and off-street loading facilities shall be provided in compliance with the Planned Development subject to the review and approval ofthe Department of Transportation and Department of Planning and Development. Any service drives, including any drive-through or other ingress or egress shall be adequately designed and paved in accordance with the regulations of the Department of Transportation in effect at the time of construction and in compliance with the Municipal Code ofthe City of Chicago, to provide ingress and egress for motor vehicles, including emergency vehicles. There will be no parking within such emergency areas. Ingress and egress shall be
 
 
APPLICANT:      URBAN FORM INVESTMENTS, LLC
ADDRESS:      500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN STREET, 501-517 NORTH GREEN STREET
DATE INTRODUCED:      APRIL 10, 2013
CHICAGO PLAN COMMISSION: JANUARY 16, 2014
 
3
 
 
 
FINAL FOR PUBLIC,
 
 
subject to the review and approval of the Department of Transportation and the Department of Planning and Development. All work proposed in the Public Way must be designed and constructed in accordance with the Chicago Department of Transportation Construction Standards for Work in the Public Way and in compliance with the Municipal Code ofthe City of Chicago. Closure of all or part of any public streets or alleys during demolition or construction shall be subject to the review and approval ofthe Chicago Department of Transportation.
  1. In addition to the maximum height of the building and any appurtenance thereto prescribed in this Planned Development, the height of any improvement shall also be subject to height limitations approved by the Federal Aviation Administration.
  2. For purposes of Floor Area Ratio (F.A.R.) calculations, the definitions in the Chicago Zoning Ordinance shall apply.
  3. Upon review and determination, "Part II Review", pursuant to Section 17-13-0610 of the Zoning Ordinance, a Part II Review Fee shall be assessed by the Department of Planning and Development. The fee, as determined by staff at the time, is final and binding on the Applicant and must be paid to the Department of Revenue prior to the issuance of any Part II approval.
 
APPLICANT: ADDRESS:
 
 
DATE IN TRODUCED: CHICAGO PLAN COMMISSION:
URBAN FORM INVESTMENTS, LLC
500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN
STREET, 501-517 NORTH GREEN STREET
APRIL 10,2013
JANUARY 16, 2014
 
 
4
 
 
FINAL FOR PUBLICATION
 
 
 
11.     The improvements on the Property shall be designed, installed and maintained in substantial conformance with the Site Plan, Landscape Plan, Green Roof Plan and Building Elevations and in accordance with the landscape provisions of the Chicago Zoning Ordinance and corresponding regulations and guidelines. Final landscape plan review and approval will be by the Department of Planning and Development. Any interim reviews associated with site plan review or Part II reviews, are conditional until final Part II approval. Applicant agrees that it will cooperate to provide space to the Chicago Transit Authority ("CTA") for the installation by the CTA of an elevator as indicated on the site plan or in a location mutually agreed upon by the CTA and Applicant.
 
 
12.     The Applicant shall comply with Rules and Regulations for the Maintenance of Stockpiles promulgated by the Commissioners of the Departments of Streets and Sanitation, Environment and Buildings, under Section 13-32-125 of the Municipal Code, or any other provision of that Code.
 
 
13.     The terms and conditions of development under this Planned Development ordinance may be modified administratively, pursuant to section 17-13-0611-A of the Zoning Ordinance by the Zoning Administrator upon the application for such a modification by
 
 
APPLICANT:      URBAN FORM INVESTMENTS, LLC
ADDRESS:      500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN STREET, 501-517 NORTH GREEN STREET
DATE INTRODUCED:      APRIL 10, 2013
CHICAGO PLAN COMMISSION: JANUARY 16, 2014
 
5
 
 
FINAL FOR PUBLICATION
 
the Applicant, its successors and assigns and, if different than the Applicant, the legal title holders and any ground lessors.
  1. The Applicant acknowledges that it is in the public interest to design, construct and maintain all buildings in a manner that provides healthier indoor environments, reduces operating costs and conserves energy and natural resources. The project will be LEED Certified and shall provide a vegetated ("green") roof on at least fifty percent (50%) of the net roof area of each building to be constructed within this Planned Development. "Net roof area" is defined as total roof area minus any required perimeter setbacks, roof top structures, and roof-mounted equipment. The total square footage of the "green roof is 12,783 square feet.
  2. The Applicant acknowledges that it is in the public interest to design, construct and maintain the project in a manner which promotes, enables, and maximizes universal access throughout the property. Plans for all buildings and improvements on the property shall be reviewed and approved by the Mayor's Office for People with Disabilities (MOPD) to ensure compliance with all applicable laws and regulations related to access for persons with disabilities and to promote the highest standard of accessibility. No building permit shall be granted by the Department of Buildings until the Director of
 
 
 
 
APPLICANT:      URBAN FORM INVESTMENTS, LLC
ADDRESS:      500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN STREET, 501-517 NORTH GREEN STREET
DATE INTRODUCED:      APRIL 10, 2013
CHICAGO PLAN COMMISSION: JANUARY 16, 2014
 
6
 
 
FINAL FOR PUBLICATION
MOPD has approved detailed construction drawings for the building or improvement proposed to be constructed pursuant to the permit.
 
 
16.     This Planned Development shall be governed by Section 17-13-0612 ofthe Zoning
Ordinance. Should this Planned Development ordinance lapse, the Zoning Administrator shall initiate a Zoning Map Amendment to rezone the property lo B2-5 Neighborhood Mixed-Use District.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
APPLICANT:      URBAN FORM INVESTMENTS, LLC
ADDRESS:      500-536 NORTH MILWAUKEE AVENUE, 806-834
WEST GRAND AVENUE, 500-522 NORTH GREEN STREET, 501-517 NORTH GREEN STREET
DATE INTRODUCED:      APRIL 10, 2013
CHICAGO PLAN COMMISSION: JANUARY 16, 2014
 
7
 
 
FINAL FOR PUbUtfuww
 
 
RESIDENTIAL BUSINESS PLANNED DEVELOPMENT No. 1027, as amended BULK REGULATIONS AND DATA TABLE
 
Gross Site Area Net Site Area
 
 
 
 
Maximum Floor Area Ratio Maximum Number of Residential Units Minimum Number of Efficiency Units Maximum Percentage of Site Coverage Number of Off Street Parking Spaces Minimum Number of Loading Spaces
 
Number of Bicycle Parking Spaces Setbacks from Property Line Maximum Building Height
 
 
Green Roof
89,575.38 sq ft (2.06 Acres)
42,019.46 sq ft (0.96 Acres)
= 89,575.38 sq ft (Gross Site Area) minus 47,555.92 sq ft (Public Streets and Alleys)
 
 
5.0
227
45
In accordance with site plan Accessory Parking, Minimum: 88 Spaces One @ 10'x25' berth in each building
(total of two berths) Minimum: 50 Spaces In accordance with site plan +179'-0" feet to top most element of building +159'-0" underside of roof structure 12,783 sq ft = 50% of applicable roof area
 
 
 
 
 
 
 
 
 
 
 
 
 
Applicant:      Urban Form Investments, LLC
Address:      500 - 536 North Milwaukee Avenue; 806 - 834 West Grand
Avenue; 500 - 522 North Green Street; and 501 - 527 North Green Street
Introduced Date:      April 10, 2013
Plan Commission Date:  January 16, 2014
 
 
 
 
 
 
 
 
 
 
O. (0
 
c 'E o
N D)
"■ยซ-> (0
"x
UJ
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ยฃ      UJ
EE      LUUJ
■5;      _J <
H      <Q
CO      >z
o
CM
> rr < z>
UJ      d<
>      SCE
"      *2
^      Hr-
rr      CC^ o
O      ยฐยฃ 8
L-      Z> o
-,      CD CO 1-
Cu <
CL 00
Z> in co
<      id co ย— "-00 Q-
z      co
  1. co
O      LU
Zi      cr
cl      Q
  1. <
 
 
 
ci <z g ^ยฐ
rยง SI
<^ 10
D_ OO
 
 
 
 
 
■! IMS I
LU O
 
 
 
 
 
 
 
 
CL (0
 
co D
TO
c
(0
 
 
 
 
 
II
H
m
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
 
LU
Z yJLU m ^
H <Q (fl >Z LU d<
> see
- ^ rr co
< m rr
3
 
CO CD CO CO ID CO
O CD O O ID CO
 
 
 
 
 
z      co
  1. CO
O      LU
□      cc
CL      Q
0.      Q
  1. <
CO
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
CM
 
rr <
3
ctO
QCO
<:ยง IO
rr el's:
Q_ OO
 
(link '      ย•  v;ii-j:-f       ยป ;- 'icfi
 
f
 
V
c
(MOb ,91)
Aamv onand
,99221 aurj Ajepunog
 
 
 
 
 
 
o
CL
o
a. o.
4-> (0
ยฎ^ E ^
o -a
 
 
 
<U ยฃ c <ยฐ
c o ro c
LU UJ
UJUJ
S3
is
=!< 5cr
ccco
Q. □
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
CO
 
 
UJ
 
 
o
rr O
LL
< CQ
rr
3
CM
      .    ^ CD
> rr <
rr
CL <
COCO CO CO
in co
Q <2
5b; IO oo
6 CD o o m co
 
 
 
 
-z-      co
  1. CO
O      LU
Zi      cc
a.      Q
Q_      O
  1. <
 
s Mint. S \J*S f VJW-.IVMtl !^!V
 
 
 
 
 
 
 
 
 
 
 
 
 
 
C ยซ
Q.
Ci ■*->
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o      .-
zl      >
EE      LLJLU
UJ >
H      <Q ft
O CM
CD" iย—
>
<
2CC
_-      xo
fr      0:03      o
O      ~
LL.      Z>      o
-7      CD CD
5=      CO CO      _j
<      ID CO      ย—
ยฃ      6 CO      f Z
~z.      co
  1. CO
  2. O      LU
Zi      OC
CL      q
D_      O
  1. <
3      ID CO      < ย—3
 
 
 
 
LU
o      ย—
LU
3      0$
O      <2
cc      or
qz oo
 
 
 
 
ย• ย• W vu i vs %  ■   *; w-'V>? ij lye
 
 
 
Agnv onand
CO
o 'c
(0
**ยง
IM- co ^ยฑ 05
CO CU
Q-c5
OO <u
_cu
D. CO
11 1
3
O C X cu
CU C m-
oa ยฐ 2'5 sS < a o
CT CO
CO CO
h-
 
 
cr
(0 O)
ยซ* in
in
ca cu
CM CO
cu
o o cc
c a> a>
O
o o rr
 
 
 
 
 
 
 
 
C
re
Q_
o o cc
c o o
o
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o       co
Z      LULU
^      3<
m      sz
o
CM
CD" iย—
> CC
<
=3
LU      =d<
>      2CC
CO
 
o      olu 8
u.      z> o
-,      COCD i-
6;      co co i
<      inoo ย—
^      b cd ?
P-      OO CL
ZD      in co <
 
 
 
 
ctO
z.      co
<      CO
O      LU
Zi      CC
Q LU O
Q O <
CL CL <
r>
 
<b; iO Q_ OO
 
PUBLICAN
 
 
 
 
 
 
 
 
 
 
 
 
 
C
o >
UJ
 
3 O
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
d-l
to
CO LU >
lulu
LU
O CM
rr O
LL
< m rr
3
 
 
Srr o
2 rr
<
3
rrco
CD CO i-CO CO I ID CD ย—
rr
ID 00    < ย—3
O CO
o o
EO oco
 
 
 
a <z
co
z      co
  1. co
O      LU
□      rr
CL      Q
CL      Q
  1. <
LU O
Q (J5
ย„,0 <2 rr 05
IO oo
 
 
 
 
 
 
 
 
 
 
 
 
 
 
c o
■4ย—'
(0
>
0)
LU +-ยป
(0
LU
o
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
UJ
ย—' >
CO
Z      LU LU
5:      -)<
H      |Q
CO      > z
LU      =J<
ro c\)
co" 1ย—
>
ย— CC
9? <
>      2CC
 
rr      ccco 0
g      oyj c
IL      Z> O
-r      CD CD t-
6:      CO CO
<      IDCO
5      OO
z      co
  1. co
O      LU
CL      O
Q_      Q
  1. <
-J      ID OO
LU
 
 
 
oco Q ย— OO
 
 
niW- ruft ryBuvยปm ivrยป
 
 
 
o
<u i_
CO
C 0)
a> s_
O E
 
 
 
<0 >
o
UJ
(/> (0 UJ
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
CO
LU
CO LU
>
 
rr O
LL
■z.
<
m rr
13
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LU LU
LULU
 
srr rr co
 
CD CD
co co
ID CO
O CD O O LD CO
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
rr
CL
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
CM
 
> CC
<
 
 
 
z co < co
O LU
CL CL <
ย— rr
Q Q <
 
-rr o|
5b= io
O_ OO
 
 
 
(D
<D tย— ■*->
CO
C <D Q> i_
o
E
 
c o
(0
> o
UJ (/)
cu
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
co
co
LU >
UJ LULU
LU
rr O
LL,
<
CD
rr
go =!<
rr co z?
CD CO CO CO ID 00
O CD O O ID 00
 
 
 
 
 
r-      
Z      CO
<      CO
Q
a <
O      LU
Zi      rr
a.
CL <
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
o
O CM
CN
> CC
rr Cl <
<
a
LU
o
Z)
a ,o
=3
 
 
 
 
So
oco 0<2 <2
t=rr O: kb= 10 q? oo
 
ORIGMM-
FINAL FOR PUBLICATION
 
 
 
 
 
 
urbanform
OCT A!    rCT AT !T  O ~ K/ 7" I  rtCJIJf JJI'
REAL. ESTATE DEVELOPMENT
 
 
January 7,2014
 
Chicago Department of Planning and Development 121 N LaSalle, Room 1006 Chicago, IL 60602 Attention: Marcia Baxter
 
Re:    Urban Form Investments, LLC
500-536 North Milwaukee Ave., 806-834 W. Grand Ave., 500-522 N. Green St 501-517 N. Green St., Chicago, Illinois (the "Project")
 
 
Dear Ms. Baxter:
 
The undersigned (the "Developer") is seeking a higher base floor area ratio for the real property commonly known as500-536 North Milwaukee Ave., 806-834 W. Grand Ave., 500-522 N. Green St., 501-517 N. Green St., on which the above residential Project is to be located. The City of Chicago Zoning Ordinance, Title 17, Chapter 17-4-1000 et seq. (the "Zoning Ordinance") requires, the Developer to acknowledge and agree that if such higher base floor area ratio is approved and residential units are constructed as part of the Project, it shall be obligated to either provide affordable housing units or contribute to the City's Affordable Housing Opportunity Fund. The Developer has agreed to provide a cash payment to the City of Chicago Affordable Housing Opportunity Fund (via the Department of Planning and Development) prior to the issuance of building permits for the project. The City has determined that for this Project, 10% of the new residential units proposed as a result ofthe planned development amendment will be required to be affordable, or alternatively, a contribution must be made in the amount of $100,000 per affordable unit. The previous planned development, approved in 2006, provided for 145 residential units. The proposed planned development provides for 227 residential units, a difference of 82 units. Therefore 8.2 units, rounded up to 9 units, must be provided or a contribution of $900,000.00 must be made. Developer's shall make a cash payment in lieu of providing the residential units and the total contribution will be $900,000.00. This letter constitutes the undersigned's written acknowledgment of such obligation and is being provided pursuant to Title 17, Chapter 17-4-1000 et seq. of the Zoning Ordinance.
 
 
Sincerely,
 
Urban Form Investments, LLC 640 N. LaSalle St. Suite 275 Chicago. IL 60654
 
Urban Form Investments, LLC
 
 
FINAL FOR PUBLICATION
 
 
 
 
 
Affordable Housing Profile Form (Rental)
Submit this form to the Department of Planning & Development for each project that triggers an affordability requirement (including CPAN, ARO, and the Density Bonus).
This completed form should be returned (via e-mail, fax, postal service or interoffice mail), to: Marcia Baxter, Department of Planning & Development, 121 N. LaSalle Street, Chicago, IL 60602. E-mail: MBaxter@cityofchicago.org Telephone: (312) 744-0696.
For information on these programs/requirements, visit www.cityofchicago.org/dpd
Date: 01/06m
SECTION 1: DEVELOPMENT INFORMATION
Development Name: 500 N. Milwaukee
Development Address: 500-536 N. Milwaukee, 606-834 W. Grand Ave., 500-522 N. Green St., 501-517 N. Green St. Ward: 27th Ward
If you are working with a Planner at the City, what is his/her name? Fred Deters
Type of City involvement:             Land write-down
(check all that apply)             Financial Assistance (ll receiving tif assistance, will TIF funds be
used for housing construction?       *)
X      Zoning increase, PD, or City Land purchase *if yes, please provide copy of the TIF Eligible Expenses
SECTION 2: DEVELOPER INFORMATION
Developer Name: Urban Form Investment, LLC Developer Contact (Project Coordinator): Michael Breheny Developer Address: 640 N. LaSalle
Email address: mbreheny@gmaii.com      May we use email to contact you?   Yes No
Telephone Number: 773-960-5705
SECTION 3: DEVELOPMENT INFORMATION
a) Affordable units required
For ARO projects:    /,:i>es.x       10%* =      \       (always round up)
Total units      total affordable units required
*20% if TIF assistance Is provided
 
For Density Bonus projects:             X 25% =      
Bonus Square Footage*   Affordable sq. footage required
*Note that the maximum allowed bonus is 20% of base FAR ln dash-5; 25% in dash-7 or -10; and 30% of base FAR in dash-12 or -16 (www.citvofchicaqo.org/zoninq for zoning info).
b) building details
In addition to water, which of the following utilities will be included In the rent (circle applicable):
Cooking gas    electric       gas heat       electric heat       other (describe on back)
Is parking included in the rent for the: affordable units? yes no markel-rale units? yes no
If parking is not included, what is the monthly cost per space?      
 
1
 
FINAL FOR PUBLICATION
 
Proposed Affordable Rent*
Estimated date for the commencement of marketing:
Estimated date for completion of construction ofthe affordable units:
Expected Market Rent
Number
of Bedroo ms/Unit
Unit Type*
Number of Units
For each unit configuration, fill out a separate row,- as applicable fsee example)
$1000
759
Example
'■4' '."
i;bed/1 bath
 
Total Square Foolage/Unlt
Affordable Units
.ย•: ย•- .800
 
 
 
Proposed Level of Affordability
(60% or less of AMI)
'■60%
 
 
 
 
Unit Mix OK to proceed?
 
 
 
Market
Rate
Units
N/A
"n/a"
N/A
N/A
N/A "N/A
 
'Rout iimnuiils iipdulutf annually Ui thu "City ol Chiciiyo's Mnilnuim AKordoble Monthly Rent Chaif
SECTION 4: PAYMENT IN LIEU OF UNITS When do you expect to make the payment -In-lleu?
(typically corresponds with issuance of building permits) Month/Year Foi ARO projects, use the'fdllovvihq-formula to calculate payment owed:
 
82
 
X $100,000 = $ 900,000
(round up to nearest whole number)
X 10% =
Amount owed
Number of total .new units since PD approved in 2006
For Density Bonus projects, use the following formula to calculate payment owed:
x 80% x $
Bonus Floor Area (sq ft)     median price per base FAR foot      Amount owed
 
.  Authorization to Proceed (to be completed by Department'6f DPD) Marcia Baxter, ?
Date
Department of Planrjjnc^& Development
 
Submarket (Table for use with the Density Bonus fees-in-lieu calculations)
Median Land Price per Base FAR Foot "$31"
Loop: Chicago River on north/west, Congress on south; Lake Shore Dr on east
North: Division on north: Chicago River on south/west: Lake Shore Dr. on east
$43
South: Congress on north; Stevenson on south; Chicago River on west; Lake Shore Dr. on east
$22
Wost: Lake on north; Congress on south: Chicaqo River on east; Racine on west
$29
 
Date
 
Developer/ProjecfCoordinator--
 
 
 
I770S
 
 
Department of Planning and Development city of chicago
 
MEMORANDUM
 
 
TO:      Alderman Daniel S. Solis
Chairman, City Council Committee on Zoning
 
 
FROM:       j" -v      
Andrew J. Mooney / Secretary | Chicago Plan Commission
 
DATE:        January 17, 2014
 
RE: Proposed amendment to Residential Business Planned Development No. 1027 forthe property generally located at 500-536 North Miwaukee, 806-834 West Grand Avenue, 500-522 North Green Street and 501-517 North Green Street.
 
 
On January 16, 2014, the Chicago Plan Commission recommended approval ofthe proposed amendment to Planned Development No. 1027 submitted by Urban Form Investments, LLC. A copy of the proposed amendment is attached. I would very much appreciate your assistance in having this introduced at the next possible City Council Committee on Zoning hearing.
 
Also enclosed is a copy of the staff report to the Plan Commission which includes the Department of Planning and Development, Bureau of Planning and Zoning recommendation and a copy ofthe Resolution. If you have any questions in this regard, please do not hesitate to contact me at 744-5777.
 
 
 
cc:    Steve Valenziano
PD Master File (Original PD, copy of memo)
 
 
 
 
 
 
 
12) NORTH LASALLE STREET, ROOM 1000, CHICAGO, ILLINOIS G0602
 
 
1/14/2014
 
 
 
 
 
 
 
1
 
1/14/2014
 
 
1/14/2014
 
 
 
 
 
 
 
3
 
1/14/2014
 
 
 
 
 
 
January 16 2014
Rendering   Vtrw hum the Northwest
 
 
FINAL
 
REPORT to the
CHICAGO PLAN COMMISSION from the
DEPARTMENT of PLANNING and DEVELOPMENT JANUARY 16, 2014
FOR APPROVAL:      AMENDMENT TO RESIDENTIAL BUSINESS PLANNED
DEVELOPMENT No. 1027
APPLICANT:      URBAN FORM INVESTMENTS, LLC
LOCATION:      500 - 536 NORTH MILWAUKEE AVENUE,
806 - 834 WEST GRAND AVENUE,
  1. - 522 NORTH GREET STREET, and
  2. - 517 NORTH GREET STREET; CHICAGO, ILLINOIS
 
Pursuant to the provisions ofthe Chicago Zoning Ordinance, Title 17 ofthe Municipal Code of Chicago, the Department of Planning and Development hereby submits this report and recommendation on a proposed amendemdment to Residential Business Planned Development No. 1027 for your review and recommendation to the Chicago City Council. The application for this amendment to the Chicago Zoning Ordinance was introduced into the City Council on April 10, 2013. Notice of the public hearing was published in the Chicago Sun-Times on January 1, 2014. The applicant was separately notified of this public hearing.
 
The applicant, Urban Form Investments, LLC, proposes to amend Residential Business Planned Development No. 1027, located in the West Town Community Area. The application proposes two mixed-use buildings, a 4-story building with 48 dwelling units and approximately 10,700 square feet of ground floor retail space and a 14-story building with 179 dwelling units, approximately 3,200 square feet of ground floor retail space, and 141 accessory parking spaces. The application would amend the existing Planned Development's Bulk Regulations and Data Table to increase the maximum Floor Area Ratio from 3.649 to 5.00, increase the maximum number of residential dwelling units from 145 to 227, decrease the number of parking spaces from 187 to 141, and increase the maximum height from 165 feet to 178 feet. The application would also incorporate a new Site Plan and Building Elevations.
 
This application is being submitted as a mandatory Planned Development amendment because it proposes to increase the maximum Floor Area Ratio and increase the number of dwelling units by more than three units.
Page 1 of 5
 
 
BACKGROUND
Residential Business Planned Development No. 1027 was approved by the Chicago City Council September 13, 2006. That Planned Development provided for a 1-story retail building and a 12-story condominium residential building with a combined total of 145 residential units, approximately 20,500 square feet of ground floor retail, and 187 parking spaces. That project was never started and the buildings that were to be demolished for it remain on the site. Prior to establishing the existing Planned Development, the site was rezoned from M1-3 Limited Manufacturing/Business Park District to B2-5 Neighborhood Mixed-Use District.
 
SITE AND AREA DESCRIPTION
The approximately 0.96-acre triangular site is located at the three-legged intersection of North Milwaukee Avenue, West Grand Avenue, and North Halsted Street. It lies on the south side of N. Milwaukee Avenue and north site of W. Grand Avenue and extends west approximately 400 feet to the alley west of North Green Street. It includes both sides of N. Green Street. The site excludes two properties at the southwest and northwest corners of the site, an approximately 75' by 40' parcel on W. Grand Avenue at the alley and a triangular parcel on N. Milwaukee Avenue at the alley. The site contains a number of vacant 1-, 2-, and 3-story commercial buildings dating from the 19th century, plus a vacant lot. All the existing buildings would be demolished. The site is adjacent to the Grand Station on CTA Blue Line subway, with an entry stair in the Grand Avenue sidewalk by the site.
 
The immediate surrounding area is a mix of older commercial uses and recent residential development. West Grand Avenue, including the 3-story building at the southwest comer of the site is largely commercial. North Milwaukee Avenue, including the 5-story building at the northwest corner ofthe site, along with N. Green Street south of W. Grand Avenue, is residential. A recent 7-story residential building at the northwest corner of N. Milwaukee Avenue and N. Halsted Street currently dominates that prominent intersection. A townhouse development lies immediately west of the site, along the alley. Most of the immediate environs are surrounded by the depressed roadways of the Kennedy Expressway and its Ohio Street feeder ramps to the west and north
 
The site is neither within an Industrial Corridor nor within a Tax Increment Financing (TIF) District. The site is not in the Lake Michigan and Chicago Lakefront Protection District, nor within a Chicago Landmark District. There are no buildings on the site that are Chicago Landmarks and no buildings that have been rated as potentially significant in the broader context of the city, state, or country ("red") or as potentially significant in the context of the surrounding community ("orange") by the Chicago Historic Resources Survey.
 
The site is well served by the Chicago Transit Authority ("CTA"). The CTA Blue line Grand station is adjacent to the site. The CTA's #8 (Halsted), #56 (Milwaukee), and #65 (Grand) bus lines also directly serve the site.
 
 
Page 2 of 5
 
 
PROJECT DESCRIPTION
Like the originally approved project, this proposal consists of two buildings, a low-rise building on the triangle defined by N. Milwaukee Avenue, W. Grand Avenue, and N. Green Street, and a high-rise building on the west side of N. Green Street. However, where the original plan called for a one-story, retail-only building on the eastern parcel, the current proposal calls for a four-story building with approximately 10,700 square feet of ground floor retail and 48 residential units on the upper three floors. The western building has grown from 12 to 14 stories and from 145 to 179 residential units. North Green Street, which would have been vacated in the original plan, would now remain a public right-of-way.
 
The ground floor of the eastern, low-rise, building would be set back approximately five feet from both N. Milwaukee Avenue and W. Grand Avenue to facilitate better pedestrian flow on these streets by the subway station. In addition, an approximately 1300-square-foot landscaped plaza would be created at the Milwaukee/Grand corner, an additional recessed area would be created on W. Grand Avenue by the existing bus shelter, and provision would be made on the property for a future elevator to the subway station. The upper three floors of the building, each containing ten residential units, would have an additional setback along N. Milwaukee Avenue, creating a shared outdoor deck. Five of the ten units on each floor would have balconies.
 
The western building would have its primary frontage on N. Green Street with lesser frontages on N. Milwaukee Avenue and W. Grand Avenue. Portions of the building's ground floor would be set back from each of those streets. The west side of the building is separated from the main 16-foot alley by a remnant 18-foot public alley, creating a building setback here, as well.
 
The ground floor of the western building would have small retail spaces at the comers of Green Street/Milwaukee Avenue and Green Street/Grand Avenue. The ground floor would also contain a residential lobby, mechanical space, and the first of four levels of parking. Beginning at the fourth floor, the residential tower would be set back 15 feet from the building to the north along N. Milwaukee Avenue and an additional 53 feet from the main alley to the west, creating a common landscaped amenity deck with swimming pool. The typical residential floor, floors 5 through 12, would have 18 dwelling units.each ; floors 13 and 14 would be set back even further from the east, west, and north, and feature fewer (10), larger units. Indoor amenity facilities would be located on the third and fourth floors of the west building.
 
DESIGN
On the low-rise building, the ground floor facades would feature a metal and glass storefront system recessed behind support columns clad with metal panels. The Grand Avenue facade would also feature a colored accent wall. The upper three floors would be clad with a mix of metal and glass window wall system and a panelized rainscreen system. Balcony railings would be metal and glass.
 
 
Page 3 of 5
 
 
Along Green Street, Milwaukee Avenue, and Grand Avenue, the ground floor of the high-rise building would also be largely clad with a metal and glass storefront system. The parking levels on the second and third floors would be screened by perforated metal screenwall system. The fourth floor parking level would be screened by prefinished metal slats. The upper, residential, floors would feature metal and glass window wall system and cast-in-place concrete floor edges. Roof-top mechanicals would be screened by a painted metal wall system. The rear ofthe four-level parking structure would feature structural elements of either dark-colored brick or board formed and sealed concrete with a metal arbor system filling the openings to encourage the growth of screening vines.
 
PARKING and ACCESS
The 141 parking spaces, all located in the west building, would consist of 121 spaces for the 227 residential units and 20 spaces for the approximately 13,800 square feet of retail/commercial space. The main parking access would be from N. Green Street, although residential parking would also have access from the alley on the west. Access to the loading dock for the east building would be from N. Green Street, that for the west building would be from the alley.
 
Pedestrian entries to the ground floor retail spaces would be located on all of the fronting streets. The two residential lobbies would be located on N. Green Street.
 
LANDSCAPING and SUSTAINABILITY
Approximately 15 trees would be installed in the parkways of N. Green Street and W. Grand Avenue. The Milwaukee Avenue sidewalks are too narrow for parkway trees, but the project would install two ground level planters in the 5-foot building setback, and the plaza at the corner of Milwaukee and Grand Avenues would be landscaped. Trees, shrubs, and ground cover would be placed on the fifth-floor amenity deck of the west building atop the podium.
 
The building would be LEED certified and have a green roof on at least 50% of the net roof area (approximately 12,783 square feet).
 
RECOMMENDATION
The Department of Planning and Development has reviewed the project materials submitted by the applicant and has concluded that the proposed amendment to Planned Development No. 1027 would be appropriate for the site for the following reasons:
 
1.) The project meets the criteria and objectives for planned developments as set forth in the Zoning Ordinance (Section 17-13-0900) and its adoption would not have any adverse impact on the public's health, safety, or welfare.
 
 
 
 
Page 4 of 5
 
  1. )    The proposed amended Planned Development conforms to the requirements of
the B2-5 Neighborhood Mixed-Use District.
 
The Floor Area Ratio (FAR) of 5.00 matches the maximum permitted in the B2-5 district (5.0). The number of residential units (227) is more than in the existing Planned Development (145) but, in the proposed mix if efficiency and non-efficiency units, would substantially conform to the requirements ofthe B2-5 district. The building's height (178 feet) is allowed to exceed that permitted in the B2-5 district (80 feet) if the building is reviewed and approved as a Planned Development. The number of parking spaces provided (141) exceeds the minimum number that would be required in the B2-5 district located within 250 feet of a transit station (88) The application proposes 20 parking spaces for the retail component; none are required The uses proposed all permitted or special uses in the B2-5 district.
  1. )     The proposed development is compatible with the character of the surrounding
area in terms of uses, density and building scale.
 
Residential uses - townhouse, low-rise and mid-rise multifamily - have become the dominant uses in the immediate area west of N. Halsted Street. The retail/commercial component of the project is scaled to suit the support needs of the residents. Although the west building would be about twice the height of any others in the immediate vicinity, its prominent location at the intersection of three major streets would create a landmark similar to other locations along N. Milwaukee Avenue.
  1. )    The public infrastructure facilities and city services will be adequate to serve the
proposed development at the time of occupancy.
 
The proposed Planned Development has been reviewed by the Chicago Department of Transportation and all requested changes have been made. Copies of this application have been circulated to other City departments and agencies and no comments have been received which have not been addressed in the revised application.
  1. )     The project would comply with the requirements for access in case of fire and
other emergencies.
 
Based on the foregoing, it is the recommendation ofthe Department of Planning and Development that the revised application for an amended Planned Development be approved and that the recommendation to the City Council Committee on Zoning, Landmarks and Building Standards be: "As Revised, Passage Recommended."
 
Department of Planning and Development
 
Page 5 of 5
 
 
Department of Planning and Development
CITY OF CHICAGO
RESIDENTIAL BUSINESS PLANNED DEVELOPMENT No. 1027, as amended (500 - 536 NORTH MILWAUKEE AVENUE, 806 - 834 WEST GRAND AVENUE, 500 - 522 NORTH GREET STREET, and 501 - 517 NORTH GREET STREET)
 
RESOLUTION
 
WHEREAS, the applicant, Urban Form Investments, LLC, proposes to amend Residential Business Planned Development No. 1027 on an approximately 0.96-acre site in the West Town Community Area; and
 
WHEREAS, the applicant proposes to construct 4- and 14-story mixed-use buildings with a combined 227 dwelling units, 13,800 square feet of retail/commercial space, and 141 parking spaces; and
 
WHEREAS, the application has been submitted as a mandatory planned development amendment because it would increase the maximum permitted Floor Area Ratio, increase the maximum number of dwelling units by more than three, and increase the height beyond 80 feet; and
 
WHEREAS, an application for Planned Development amendment approval was introduced into the City Council on April 10, 2013; and
 
WHEREAS, notice of the public hearing to consider the application was published in the Chicago Sun-Times on January 1, 2014; the applicant was notified of the hearing; and the proposed Planned Development application was considered at a public hearing by this Plan Commission on January 16, 2014; and
 
WHEREAS, this Plan Commission has reviewed the application with respect to the Planned Development provisions ofthe Chicago Zoning Ordinance and finds that the proposal would be consistent with that ordinance; and
 
WHEREAS, the Department of Planning and Development recommends approval of the application, which recommendation and the reasons therefore are contained in the Department's written report dated January 16, 2014, a copy of which is attached hereto and made a part hereof; and
 
 
 
 
12] NORTH LASALLE STREET. ROOM 1000. CHICAGO, ILLINOIS 60G02
 
WHEREAS, this Plan Commission has fully reviewed the application and all
information submissions associated with the proposed development, the report and recommendation of the Department of Planning and Development, and all other testimony presented at the public hearing held on January 16, 2014, giving due consideration to the Planned Development Standards and Guidelines contained in the Chicago Zoning Ordinance;
 
 
NOW, THEREFORE, BE IT RESOLVED BY THE CHICAGO PLAN COMMISSION:
  1. THAT the final application for a Planned Development amendment, dated January 16, 2014, be approved as being in conformance with the provisions, terms and conditions of the Chicago Zoning Ordinance; and
  2. THAT this Plan Commission recommends approval to the City Council Committee on Zoning, Landmarks and Building Standards ofthe final Planned Development Amendment Application, dated January 16, 2014; and
  3. THAT the above-stated recitals to this resolution, together with the report ofthe Department of Planning and Development, be adopted as the findings of fact of the Chicago Plan Commission regarding this Planned Development Amendment Application.
 
 
 
Approved: January 16, 2014
i
 
RBPD No. 1027, as amended
 
2JX3
 
JAH
1 f>
 
 
CITY OF CHICAGO
 
APPLICATION FOR AN AMENDMENT TO THE CHICAGO ZONING ORDINANCE
 
 
ADDRESS of the property Applicant is seeking to rezone: 500-536 N. Milwaukee, 806-834 W. Grand Ave., 500-522 N. Green St., 501-517 N. Gr?
 
Ward Number that property is located in:_27      
APPLICANT Urban Form Investments, LLC
 
CITY Chicago
PHONE 773-960-5705
ADDRESS 640 N- LaSalle #275
STATEjL      
ZIP CODE 60610
 
.CONTACT PERSON M'ke Breheny
 
 
NO*
Is the applicant the owner of the property? YES      
If the applicant is not the owner of the property, please provide the following information regarding the owner and attach written authorization from the owner allowing the application to proceed.
 
OWNER Irving Naiditch & Marilyn Naiditch      
 
CITY Chicago
PHONE 773-478-6300
ADDRESS 400 w- Victoria St
STATE JL      
ZIP CODE 60646
 
CONTACT PERSON Irving Naiditch
 
 
If the Applicant/Owner of the property has obtained a lawyer as their representative for the rezoning, please provide the following information:
 
ATTORNEY Jo"" J- George      
 
ADDRESS 180 N- Stetson Ave., Two Prudential Plaza, Suite 3700
 
CITY Chicago      
 
PHONE 312-565-8439
STATE JL      ZIP CODE 60601      
FAX 312-565-8300      EMAIL jgeorge@srcattorneys.com
 
 
6.
If the applicant is a legal entity (Corporation. LLC, Partnership, etc.) please provide the names
of all owners as disclosed on the Economic Disclosme Statements.
Mike Breheny      
Rajen Shastri
    1. On what date did the owner acquire legal title to the subject property? 40 years ago
8.      Has the present owner previously rczoncd this properly0 Tf yes, when? Yes, 2006
 
 
Residential Business Planned      Residential Business Planned Development
  1. Present Zoning District Development No. 1027 Proposed Zoning District No. 1027, as amended
  2. Lot size in square fect (or dimensions) 58,042 s.f.      
  3. Current Use of the property vacant commercial buildings      
  4. Reason for rezoning the property To allow for construction of mixed-use development.      
 
 
 
13.     Describe the proposed use of the property after the rezoning. Indicate the number of dwelling units; number of parking spaces; approximate square footage of any commercial space; and height of the proposed building. (BE SPECIFIC)
Please see attached Planned Development Statements anrt Fxhihits fnr arlHitinnal rWail      
 
 
 
 
14.     On May 14L, 2007, the Chicago City Council passed the Affordable Requirements Ordinance (ARO) that requires on-site affordable housing units or a financial contribution if residential housing projects receive a zoning change under certain circumstances. Based on the lot size of the project in question and the proposed zoning classification, is this project subject to the Affordable Requirements Ordinance? (Sec Fact Sheet for more information)
 
NO.
 
YES*
 
COUNTY OF COOK STATE OF ILLINOIS
 
Mike Breheny
 
 
_. beina first duly sworn on oath, states that all of" the above
 
.statements and the statements contained in the documents submitted herewith are true and correct.
 
 
 
 
Signature of Apylicant
 
 
 
 
Subscribed and Sworn to before mc this
rQ1^    day of .April      20 13
 
OFFICIAL SEAL
DEBRA A. FLANAGAN
NOTARY PUBLIC, STATE OF ILLINOIS My Commission Expires 08/21/2016
 
For Office Use Only
Notary Public
 
 
 
 
Date of Introduction:. File Number:
Ward:.
 
Chicago BuildsGreen
 
500 North Milwaukee
 
 
 
 
 
Project Name:
 
 
* Street Number (if the address only includes one street number, please fill only the cell "From")
 
Project Location:
 
500
536
N
Milwaukee
Ave
Ward No-    Community Area No:
27
 
Project Type:
Check applicable:
^Planned Development    □Redevelopment Agreement □Zoning Change
h PD No: Il027i      h RDA No: I     1      UFrom: I ho:
 
□Public project
Total vehicular use area in sq.ft ย•
Total land area in sq ft:
□Landmark
Total building(s) footprint in sq ft.:
 
14,235
42,019
36,238
Enter First Name Last Name
Frederick Deters
Select project category
Res. 4 or more Market Rate
Project Size:
DPD Project Manager: BG/GR Matrix:
 
Check applicable
Financial Incentives: □"TIF
□grif
□SBIF
□Land Sale Write Down
□Empowerment Zone Grant     □Class L □ind. Dev. Revenue Bonds      □Class 6b □Bank Participation Loan □DOH
 
 
 
Density Bonus:
Check applicable:
□Public plaza & pocket park
□Chicago Riverwalk improvements
□Winter gardens
□indoor through-block connection
□Sidewalk widening
□Arcades
□Water features in a plaza or pocket park □Setbacks above the ground floor □Lower level planting terrace □Green roof
□Underground parking and loading □Concealed above-ground parking
 
Page 1 of 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chicago Builds Green
 
 
 
Landscaping:
 
 
 
 
 
7' Landscape Setback Interior Landscape Area No. of Interior Trees No. of Parkway Trees
 
 
 
 
 
Square footage Square footage'
Required per Zoning vJS;. ;"?.
;:Code or Green ;v .ijo be Proyided by^ ! -Roof/Building Greeri: i'the development: i Matrix ;; ^^:;.;V;:^^;:-;S: Please fill, if applicable
 
.n/a
 
 
 
ย• ■ ::n/a'
 
■v.---/ n/a'
 
 
 
Open Space:
 
River Setback      Square foo/age
Private Open Space      Square footage-
Privately developed Public Open Space square footage
■/'ย•n/a'
 
. n/a
 
ย• -;',:.   -■ ' n/a
;;v My.
 
 
 
Stormwater Management (At-grade volume control):
Permeable paving Raingarden Filter strip Bioswale Detention pond Native landscaping Rain-water collection cistern/barrel Total impervious area reduction
 
Square footage
Check applicable: '^ rh "\ '■'■LiJ'-'?'*'?.--. .
 
 
 
Square footage.
Gallons Square lootagc
 
 
 
Other sustainable surface treatments:
Green roof Energy Star roof High-albedo pavement
 
Square footage: Square footage
 
■ :" 12,775
; 12,783
.:"     . o
 
Square foofage
 
 
 
Transportation:
 
No. of accessory parking spaces
Total no. of parking spaces (Accessory + Non- Acc.) No. of parking spaces dedicated to car sharing services (E.g.: I-Go, Zip-Car)
No. of bicycle parking
Within 600 ft of CTA or Metra station entrance
■' 'Sv. ■: 89.
 
 
 
'" o
 
 
 
Check if applicable:(
 
Page 2ol 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chicago Builds Green
 
Building Certification:
 
Energy Star building LEED certification
LEED Certified
LEED Silver
LEED Gold
LEED Platinum Chicago Green Homes
Chicago Green Homes [one-star]
Chicago Green Homes [two-star]
Chicago Green Homes [three-star]
 
 
 
 
 
 
 
Energy efficiency strategies not captured above:
-IE: Other than Energy Star Root - or Energy Star Building Certification-
 
■■ttf.-t'j.Vi J5V ■
 
 
Other sustainable strategies and/or Project Notes:
 
ย•i-i -K','V.\'
 
Page 3 of 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chicago Builds Green
 
 
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
SECTION I -- GENERAL INFORMATION
  1. Legal name of the Disclosing Party submitting this EDS. Include d/b/a/ if applicable:
Urban Form Investments, LLC      
 
Check ONE of the following three boxes:
 
Indicate whether the Disclosing Party submitting this EDS is:
  1. [x] the Applicant
OR
  1. [ ] a legal entity holding a direct or indirect interest in the Applicant. State the legal name of the
Applicant in which the Disclosing Party holds an interest:      
OR
3.      [ ] a legal entity with a right of control (see Section Il.B.l.) State the legal name ofthe entity in
which the Disclosing Party holds a right of control:      
u   o    ย•      r-u   rv   i      n   t      640 N. LaSalle #275
  1. Business address or the Disclosing Party:       .      
Chicago, IL 60610
  1. Telephone: 773-960-5705      Fax: None      Email: mbreheny@gmail.com
  2. Name of contact person: Mike Breheny      
  3. Federal Employer Identification No. (if you have one):       
  1. Brief description of contract, transaction or other undertaking (referred to below as the "Matter") to which this EDS pertains. (Include project number and location of property, if applicable):
 
Application for amendment to Planned Development No. 1027 located at 500-536 N. Milwaukee, 806-834 N. Grand Ave., 500-522 N. Green St., 501-517 N. Green St.
  1. Which City agency or department is requesting this EDS? DHED      
 
If the Matter is a contract being handled by the City's Department of Procurement Services, please complete the following:
 
Specification #      and Contract #      
 
Vcr. 01-01-12
 
 
 
Page 1 of 13
 
 
SECTION II -- DISCLOSURE OF OWNERSHIP INTERESTS
 
A. NATURE OF THE DISCLOSING PARTY
 
1.   Indicate the nature of the Disclosing Party:
[ ] Person      [X]      Limited liability company
[ ] Publicly registered business corporation      [ ]      Limited liability partnership
[ ] Privately held business corporation      [ |      Joint venture
[] Sole proprietorship      []      Not-for-profit corporation
[ ] General partnership      (Is      the not-for-profit corporation also a 501(c)(3))?
[ ] Limited partnership      [ ] Yes      f ] No
[ ] Trust      []      Other (please specify)
  1. For legal entities, the state (or foreign country) of incorporation or organization, if applicable:
  2. Delaware      
3.      For legal entities not organized in the State of Illinois: Has the organization registered to do business in the State of Illinois as a foreign entity?
 
[Xl Yes      [ ] No      [ J N/A
 
B. IF THE DISCLOSING PARTY IS A LEGAL ENTITY:
 
1.   List below the full names and titles of all executive officers and all directors of the entity. NOTE: For not-for-profit corporations, also list below all members, if any, which are legal entities. If there are no such members, write "no members." For trusts, estates or other similar entities, list below the legal titleholder(s).
If the entity is a general partnership, limited partnership, limited liability company, limited liability partnership or joint venture, list below the name and title of each general partner, managing member, manager or any other person or entity that controls the day-to-day management of the Disclosing Party. NOTE: Each legal entity listed below must submit an EDS on its own behalf.
 
Name Title Rajen Shastri Member
Michael Breheny Member
 
 
 
 
 
2.   Please provide the following information concerning each person or entity having a direct or indirect beneficial interest (including ownership) in excess of 7.5% ofthe Disclosing Party. Examples of such an interest include shares in a corporation, partnership interest in a partnership or joint venture,
 
Page 2 of 13
 
 
interest of a member or manager in a limited liability company, or interest of a beneficiary of a trust, estate or other similar entity. If none, slate "None." NOTE: Pursuant to Section 2-154-030 ofthe Municipal Code of Chicago ("Municipal Code"), the City may require any such additional information from any applicant which is reasonably intended to achieve full disclosure.
 
Name      Business Address      Percentage Interest in the
Disclosing Party
Rajen Shastri      640 N. LaSalle, Chicago, IL 60610       [16J>%      
Michael Breheny      640 N. LaSalle, Chicago, IL 60610 33.3%
 
 
 
 
 
SECTION III - BUSINESS RELATIONSHIPS WITH CITY ELECTED OFFICIALS
 
Has the Disclosing Party had a "business relationship," as defined in Chapter 2-156 of the Municipal Code, with any City elected official in the 12 months before the date this RDS is signed?
 
[ ] Yes      [>] No
 
If yes, please identify below the name(s) of such City elected official(s) and describe such rclationship(s):
 
 
 
 
SECTION IV - DISCLOSURE OF SUBCONTRACTORS AND OTHER RETAINED PARTIES
 
The Disclosing Party must disclose the name and business address of each subcontractor, attorney, lobbyist, accountant, consultant and any other person or entity whom the Disclosing Party has retained or expects to retain in connection with the Matter, as well as the nature of the relationship, and the total amount of the fees paid or estimated to be paid. The Disclosing Party is not required to disclose employees who are paid solely through the Disclosing Party's regular payroll.
 
"Lobbyist" means any person or entity who undertakes to influence any legislative or administrative action on behalf of any person or entity other than: (1) a not-for-profit entity, on an unpaid basis, or (2) himself. "Lobbyist" also means any person or entity any part of whose duties as an employee of another includes undertaking to influence any legislative or administrative action.
 
If the Disclosing Party is uncertain whether a disclosure is required under this Section, the Disclosing Party must either ask the Cily whether disclosure is required or make the disclosure.
 
 
 
 
 
Page 3 of 13
 
 
Name (indicate whether     Business      Relationship to Disclosing Party      Fees (indicate whether
retained or anticipated       Address       (subcontractor, attorney,      paid or estimated.) NOTE:
to be retained)      lobbyist, etc.)      "hourly rate" or "t.b.d." is
not an acceptable response.
John J George      180 N. Stetson Ave.      Attorney      Est. $25,000
Two Prudential, Suite 3700
Chicago, IL 60601
 
(Add sheets if necessary)
[ ] Check here if the Disclosing Party has not retained, nor expects to retain, any such persons or entities. SECTION V - CERTIFICATIONS
  1. COURT-ORDERED CHILD SUPPORT COMPLIANCE
Under Municipal Code Section 2-92-415, substantial owners of business entities that contract with the City must remain in compliance with their child support obligations throughout the contract's term.
 
Has any person who directly or indirectly owns 10% or more ofthe Disclosing Party been declared in arrearage on any child support obligations by any Illinois court of competent jurisdiction?
 
[ ] Yes      [X] No      [ ] No person directly or indirectly owns 10% or more of the
Disclosing Party.
 
If "Yes," has the person entered into a court-approved agreement for payment of all support owed and is the person in compliance with that agreement?
 
[]Yes []No
  1. FURTHER CERTIFICATIONS
 
1.   Pursuant to Municipal Code Chapter 1-23, Article 1 ("Article I")(which the Applicant should consult for defined terms (e.g., "doing business") and legal requirements), if the Disclosing Party submitting this EDS is the Applicant and is doing business with the City, then the Disclosing Party certifies as follows: (i) neither the Applicant nor any controlling person is currently indicted or charged with, or has admitted guilt of, or has ever been convicted of, or placed under supervision for, any criminal offense involving actual, attempted, or conspiracy to commit bribery, theft, fraud, forgery, perjury, dishonesty or deceit against an officer or employee ofthe City or any sister agency; and (ii) the Applicant understands and acknowledges that compliance with Article I is a continuing requirement for doing business with the City. NOTE: If Article I applies to the Applicant, the permanent compliance timeframe in Article I supersedes some five-year compliance timeframes in certifications 2 and 3 below.
 
 
Page 4 of 13
 
  1. The Disclosing Party and, if the Disclosing Party is a legal entity, all of those persons or entities identified in Section Il.B.l. of this EDS:
    1. are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from any transactions by any federal, state or local unit of government;
    2. have not, within a five-year period preceding the date of this EDS, been convicted of a criminal offense, adjudged guilty, or had a civil judgment rendered against them in connection with: obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; a violation of federal or state antitrust statutes; fraud; embezzlement; theft; forgery; bribery; falsification or destruction of records; making false statements; or receiving stolen property;
    3. are not presently indicted for, or criminally or civilly charged by, a governmental entity (federal, state or local) with committing any ofthe offenses set forth in clause B.2.b. of this Section V;
    4. have not, within a five-year period preceding the date of this EDS, had one or more public transactions (federal, state or local) terminated for cause or default; and
    5. have not, within a five-year period preceding the date of this EDS, been convicted, adjudged guilty, or found liable in a civil proceeding, or in any criminal or civil action, including actions concerning environmental violations, instituted by the City or by the federal government, any state, or any other unit of local government.
  1. The certifications in subparts 3, 4 and 5 concern:
  • the Disclosing Party;
ย•      any "Contractor" (meaning any contractor or subcontractor used by the Disclosing Party in connection with the Matter, including but not limited to all persons or legal entities disclosed under Section IV, "Disclosure of Subcontractors and Other Retained Parties");
  • any "Affiliated Entity" (meaning a person or entity that, directly or indirectly: controls the Disclosing Party, is controlled by the Disclosing Party, or is, with the Disclosing Party, under common control of another person or entity. Indicia of control include, without limitation: interlocking management or ownership; identity of interests among family members, shared facilities and equipment; common use of employees; or organization of a business entity following the ineligibility of a business entity to do business with federal or state or local government, including the City, using substantially the same management, ownership, or principals as the ineligible entity); with respect to Contractors, the term Affiliated Entity means a person or entity that directly or indirectly controls the Contractor, is controlled by it, or, with the Contractor, is under common control of another person or entity;
  • any responsible official of the Disclosing Party, any Contractor or any Affiliated Entity or any other official, agent or employee of the Disclosing Party, any Contractor or any Affiliated Entity, acting pursuant to the direction or authorization of a responsible official ofthe Disclosing Party, any Contractor or any Affiliated Entity (collectively "Agents").
 
 
Page 5 of 13
 
 
Neither the Disclosing Party, nor any Contractor, nor any Affiliated Entity of either the Disclosing Party or any Contractor nor any Agents have, during the five years before the date this EDS is signed, or, with respect to a Contractor, an Affiliated Entity, or an Affiliated Entity of a Contractor during the five years before the date of such Contractor's or Affiliated Entity's contract or engagement in connection with the Matter:
    1. bribed or attempted to bribe, or been convicted or adjudged guilty of bribery or attempting to bribe, a public officer or employee ofthe City, the State of Illinois, or any agency of the federal government or of any state or local government in the United States of America, in that officer's or employee's official capacity;
    2. agreed or colluded with other bidders or prospective bidders, or been a party to any such agreement, or been convicted or adjudged guilty of agreement or collusion among bidders or prospective bidders, in restraint of freedom of competition by agreement to bid a fixed price or otherwise; or
    3. made an admission of such conduct described in a. or b. above that is a matter of record, but have not been prosecuted for such conduct; or
  1. violated the provisions of Municipal Code Section 2-92-610 (Living Wage Ordinance).
  1. Neither the Disclosing Party, Affiliated Entity or Contractor, or any of their employees, officials, agents or partners, is barred from contracting with any unit of state or local government as a result of engaging in or being convicted of (1) bid-rigging in violation of 720 ILCS 5/33E-3; (2) bid-rotating in violation of 720 ILCS 5/33E-4; or (3) any similar offense of any state or of the United States of America that contains the same elements as the offense of bid-rigging or bid-rotating.
  2. Neither the Disclosing Party nor any Affiliated Entity is listed on any of the following lists maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the Bureau of Industry and Security ofthe U.S. Department of Commerce or their successors: the Specially Designated Nationals List, the Denied Persons List, the Unverified List, the Entity List and the Debarred List.
  3. The Disclosing Party understands and shall comply with the applicable requirements of Chapters 2-55 (Legislative Inspector General), 2-56 (Inspector General) and 2-156 (Governmental Ethics) of the Municipal Code.
 
7.      If the Disclosing Party is unable to certify to any of the above statements in this Part B (Further
Certifications), the Disclosing Party must explain below: N/A
 
 
 
 
 
 
 
Page 6 of 13
 
 
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
 
8.   To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all current employees of the Disclosing Party who were, at any time during the 12-month period preceding the execution date of this EDS, an employee, or elected or appointed official, of the City of Chicago (if none, indicate with "N/A" or "none"). None
 
 
 
9.   To the best ofthe Disclosing Party's knowledge after reasonable inquiry, the following is a complete list of all gifts that the Disclosing Party has given or caused to be given, at any time during the 12-month period preceding the execution date of this EDS, to an employee, or elected or appointed official, of the City of Chicago. For purposes of this statement, a "gift" does not include: (i) anything made generally available to City employees or to the general public, or (ii) food or drink provided in the course of official City business and having a retail value of less than $20 per recipient (if none, indicate with "N/A" or "none"). As to any gift listed below, please also list the name ofthe City recipient. None
 
 
C. CERTIFICATION OF STATUS AS FINANCIAL INSTITUTION
  1. The Disclosing Party certifies that the Disclosing Party (check one)
[ ] is      [X] is not
a "financial institution" as defined in Section 2-32-455(b) ofthe Municipal Code.
  1. If the Disclosing Party IS a financial institution, then the Disclosing Party pledges:
"We are not and will not become a predatory lender as defined in Chapter 2-32 of the Municipal Code. We further pledge that none of our affiliates is, and none of them will become, a predatory lender as defined in Chapter 2-32 ofthe Municipal Code. We understand that becoming a predatory lender or becoming an affiliate of a predatory lender may result in the loss of the privilege of doing business with the City."
 
If the Disclosing Party is unable to make this pledge because it or any of its affiliates (as defined in Section 2-32-455(b) of the Municipal Code) is a predatory lender within the meaning of Chapter 2-32 ofthe Municipal Code, explain here (attach additional pages if necessary):
 
 
 
 
Page 7 of 13
 
 
If the letters "NA," the word "None," or no response appears on the lines above, it will be conclusively presumed that the Disclosing Party certified to the above statements.
 
D. CERTIFICATION REGARDING INTEREST IN CITY BUSINESS
 
Any words or terms that are defined in Chapter 2-156 of the Municipal Code have the same meanings when used in this Part D.
  1. In accordance with Section 2-156-110 ofthe Municipal Code: Does any official or employee of the City have a financial interest in his or her own name or in the name of any other person or entity in the Matter?
[ ] Yes      [Xj No
 
NOTE:  If you checked "Yes" to Item D.L, proceed lo Items D.2. and D.3. If you checked "No" to Item D.l., proceed to Part E.
  1. Unless sold pursuant to a process of competitive bidding, or otherwise permitted, no City elected official or employee shall have a financial interest in his or her own name or in the name of any other person or entity in the purchase of any property that (i) belongs to the City, or (ii) is sold for taxes or assessments, or (iii) is sold by virtue of legal process at the suit, ofthe City (collectively, "City Property Sale"). Compensation for property taken pursuant to the City's eminent domain power does not constitute a financial interest within the meaning of this Part D.
 
Does the Matter involve a City Property Sale?
 
[ ] Yes      [ ] No
  1. If you checked "Yes" to Item D.l., provide the names and business addresses of the City officials or employees having such interest and identify the nature of such interest:
 
Name      Business Address      Nature of Interest
 
 
 
 
 
 
4. The Disclosing Party further certifies that no prohibited financial interest in the Matter will be acquired by any City official or employee.
 
E. CERTIFICATION REGARDING SLAVERY ERA BUSINESS
 
Please check cither 1. or 2. below. If the Disclosing Party checks 2., the Disclosing Party must disclose below or in an attachment to this EDS all information required by paragraph 2. Failure to
Page 8 of 13
 
 
comply with these disclosure requirements may make any contract entered into with the City in connection with the Matter voidable by the City.
 
_X      1. The Disclosing Party verifies that the Disclosing Party has searched any and all records of
the Disclosing Party and any and all predecessor entities regarding records of investments or profits from slavery or slaveholder insurance policies during the slavery era (including insurance policies issued to slaveholders that provided coverage for damage to or injury or death of their slaves), and the Disclosing Party has found no such records.
 
      2. The Disclosing Party verifies that, as a result of conducting the search in step 1 above, the
Disclosing Party has found records of investments or profits from slavery or slaveholder insurance policies. The Disclosing Party verifies that the following constitutes full disclosure of all such records, including the names of any and all slaves or slaveholders described in those records:
 
 
 
 
 
 
SECTION VI    CERTIFICATIONS FOR FEDERALLY FUNDED MATTERS
 
NOTE: If the Matter is federally funded, complete this Section VI. If the Matter is not federally funded, proceed to Section VII. For purposes of this Section VI, tax credits allocated by the City and proceeds of debt obligations of the City are not federal funding.
 
A. CERTIFICATION REGARDING LOBBYING
 
1.   List below the names of all persons or entities registered under the federal Lobbying Disclosure Act of 1995 who have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter: (Add sheets if necessary):
 
 
 
 
(If no explanation appears or begins on the lines above, or if the letters "NA" or if the word "None" appear, it will be conclusively presumed that the Disclosing Party means that NO persons or entities registered under the Lobbying Disclosure Act of 1995 have made lobbying contacts on behalf of the Disclosing Party with respect to the Matter.)
 
2.   The Disclosing Party has not spent and will not expend any federally appropriated funds to pay any person or entity listed in Paragraph A.l. above for his or her lobbying activities or to pay any person or entity to influence or attempt to influence an officer or employee of any agency, as defined by applicable federal law, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress, in connection with the award of any federally funded contract, making any federally funded grant or loan, entering into any cooperative agreement, or to extend, continue, renew, amend, or modify any federally funded contract, grant, loan, or cooperative agreement.
Page 9 of 13
 
  1. The Disclosing Party will submit an updated certification at the end of each calendar quarter in which there occurs any event that materially affects the accuracy ofthe statements and information set forth in paragraphs A.l. and A.2. above.
  2. The Disclosing Party certifies that either: (i) il is not an organization described in section 50 1 (c)(4) of the Internal Revenue Code of 1986; or (ii) il is an organization described in section 501(c)(4) ofthe Internal Revenue Code of 1986 but has not engaged and will hot engage in "Lobbying Activities".
  3. If the Disclosing Party is the Applicant, the Disclosing Party must obtain certifications equal in form and substance to paragraphs A.l. through A.4. above from all subcontractors before it awards any subcontract and the Disclosing Party must maintain all such subcontractors' certifications for the duration ofthe Matter and must make such certifications promptly available to the City upon request.
 
 
B. CERTIFICATION REGARDING EQUAL EMPLOYMENT OPPORTUNITY
 
If the Matter is federally funded, federal regulations require the Applicant and all proposed subcontractors to submit the following information with their bids or in writing at the outset of negotiations.
Is the Disclosing Party the Applicant?
[ ] Yes      [ ] No
If "Yes," answer the three questions below:
  1. Have you developed and do you have on file affirmative action programs pursuant to applicable federal regulations? (See 41 CFR Part 60-2.)
[ ] Yes      [ ] No
  1. Have you filed with the Joint Reporting Committee, the Director ofthe Office of Federal Contract Compliance Programs, or the Equal Employment Opportunity Commission all reports due under the applicable filing requirements?
[ ] Yes      [ ] No
  1. Have you participated in any previous contracts or subcontracts subject to the equal opportunity clause?
[ ] Yes      [ ] No
 
If you checked "No" to question 1. or 2. above, please provide an explanation:
 
 
 
 
Page 10 of 13
 
 
SECTION VII-- ACKNOWLEDGMENTS, CONTRACT INCORPORATION, COMPLIANCE, PENALTIES, DISCLOSURE
 
The Disclosing Party understands and agrees that:
  1. The certifications, disclosures, and acknowledgments contained in this EDS will become part of any contract or other agreement between the Applicant and the City in connection with the Matter, whether procurement, City assistance, or other City action, and are material inducements lo the City's execution of any contract or taking other action with respect to the Matter. The Disclosing Party understands that it must comply with all statutes, ordinances, and regulations on which this EDS is based.
  2. The City's Governmenlal Ethics and Campaign Financing Ordinances, Chapters 2-156 and 2-164 of the Municipal Code, impose certain duties and obligations on persons or entities seeking City contracts, work, business, or transactions. The full text of these ordinances and a training program is available on line at www.cityofchicago.org/Ethics, and may also be obtained from the City's Board of Ethics, 740 N.
 
Sedgwick St., Suite 500, Chicago, IL 60610, (312) 744-9660. The Disclosing Party must comply fully with the applicable ordinances.
  1. If the City determines that any information provided in this EDS is false, incomplete or inaccurate, any contract or other agreement in connection with which it is submitted may be rescinded or be void or voidable, and the City may pursue any remedies under the contract or agreement (if not rescinded or void), at law, or in equity, including terminating the Disclosing Party's participation in the Matter and/or declining to allow the Disclosing Party to participate in other transactions with the City. Remedies at law for a false statement of material fact may include incarceration and an award to the City of treble damages.
  2. It is the City's policy to make this document available to the public on its Internet site and/or upon request. Some or all of the information provided on this EDS and any attachments to this EDS may be made available to the public on the Internet, in response to a Freedom of Information Act request, or otherwise. By completing and signing this EDS, the Disclosing Party waives and releases any possible rights or claims which it may have against the City in connection with the public release of information contained in this EDS and also authorizes the City to verify the accuracy of any information submitted in this EDS.
 
E.      The information provided in this EDS must be kept current. In the event of changes, the Disclosing
Party must supplement this EDS up to the time the City takes action on the Matter. If the Matter is a
contract being handled by the City's Department of Procurement Services, the Disclosing Party must
update this EDS as the contract requires. NOTE: With respect to Matters subject to Article 1 of
Chapter 1-23 ofthe Municipal Code (imposing PERMANENT INELIGIBILITY for certain specified
offenses), the information provided herein regarding eligibility must be kept current for a longer period,
as required by Chapter 1 -23 and Section 2-154-020 of the Municipal Code.
 
The Disclosing Party represents and warrants that:
 
Page 11 of 13
 
F.l.    The Disclosing Party is not delinquent in the payment of any tax administered by the Illinois Department of Revenue, nor arc the Disclosing Party or its Affiliated Entities delinquent in paying any fine, fee, tax or other charge owed to the City. This includes, but is not limited to, all water charges, sewer charges, license fees, parking tickets, property taxes or sales taxes.
 
F.2     If the Disclosing Parly is the Applicant, the Disclosing Party and its Affiliated Entities will not use, nor permit their subcontractors to use, any facility listed by the U.S. E.P.A. on the federal Excluded Parties List System ("EPLS") maintained by the U. S. General Services Administration.
 
F.3     If the Disclosing Party is the Applicant, the Disclosing Party will obtain from any contractors/subcontractors hired or to be hired in connection with the Matter certifications equal in form and substance to those in F.l. and F.2. above and will not, without the prior written consent of the City, use any such contractor/subcontractor that docs not provide such certifications or that the Disclosing Party has reason to believe has not provided or cannot provide truthful certifications.
 
NOTE: If the Disclosing Party cannot certify as to any of the items in F.l., F.2. or F.3. above, an explanatory statement must be attached lo this EDS.
 
CERTIFICATION
 
Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS and Appendix A (if applicable) on behalf ofthe Disclosing Party, and (2) warrants that all certifications and statements contained in this EDS and Appendix A (if applicable) are true, accurate and complete as ofthe date furnished to the City.
 
Urban Form Investments, LLC
(Print or type name of Disclosing Party)
 
By::_Js
(Sign here)
 
 
Mike Breheny
(Print or type name of person signing)
 
Member      .,      
(Print or type title of person signing)
 
OFFICIAL SEAL
., DEBRA A. FLANAGAN
NOTARY PUBLIC, STATE OF ILLINOIS My Commission Expires 08/21/2016
 
at
state).
^Hl3
 
 
Signed and sworn to before me on (date
O.LA-li . County,
NJU-K*.  C,\,    Cj^t ยป■-r>-v.f^v^Notary Public.
 
Page 12 of 13
Commission expires:
 
 
CITY OF CHICAGO ECONOMIC DISCLOSURE STATEMENT AND AFFIDAVIT
APPENDIX A
 
 
 
FAMILIAL RELATIONSHIPS WITH ELECTED CITY OFFICIALS AND DEPARTMENT HEADS
 
 
This Appendix is to be completed only by (a) the Applicant, and (b) any legal entity which has a direct ownership interest in the Applicant exceeding 7.5 percent. It is not to be completed by any legal entity which has only an indirect ownership interest in the Applicant.
 
Under Municipal Code Section 2-154-015, the Disclosing Party must disclose whether such Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently has a "familial relationship" with any elected city official or department head. A "familial relationship" exists if, as of the date this EDS is signed, the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof is related to the mayor, any alderman, the city clerk, the city treasurer or any city department head as spouse or domestic partner or as any ofthe following, whether by blood or adoption: parent, child, brother or sister, aunt or uncle, niece or nephew, grandparent, grandchild, father-in-law, mother-in-law, son-in-law, daughter-in-law, stepfather or stepmother, stepson or stepdaughter, stepbrother or stepsister or half-brother or half-sister.
 
"Applicable Party" means (1) all executive officers of the Disclosing Party listed in Section Il.B.l .a., if the Disclosing Party is a corporation; all partners of the Disclosing Party, if the Disclosing Party is a general partnership; all general partners and limited partners ofthe Disclosing Party, if the Disclosing Party is a limited partnership; all managers, managing members and members ofthe Disclosing Party, if the Disclosing Party is a limited liability company; (2) all principal officers ofthe Disclosing Party; and (3) any person having more than a 7.5 percent ownership interest in the Disclosing Party. "Principal officers" means the president, chief operating officer, executive director, chief financial officer, treasurer or secretary of a legal entity or any person exercising similar authority.
 
Does the Disclosing Party or any "Applicable Party" or any Spouse or Domestic Partner thereof currently have a "familial relationship" with an elected city official or department head?
 
[ ] Yes      [X] No
 
If yes, please identify below (1) the name and title of such person, (2) the name ofthe legal entity to which such person is connected; (3) the name and title ofthe elected city official or department head to whom such person has a familial relationship, and (4) the precise nature of such familial relationship.
 
 
 
 
 
 
 
 
 
 
Page 13 of 13
 
 
(DO NOT SUBMIT THIS PAGE WITH YOUR EDS. The purpose of this page is for you to recertify your EDS prior to submission to City Council or on the date of closing. If unable to recertify truthfully, the Disclosing Party must complete a new EDS with correct or corrected information)
 
RECERTIFICATION
 
Generally, for use with City Council matters. Not for City procurements unless requested.
 
This recertification is being submitted in connection with 500 N. Hilwaukee pd Amendment [identify the Matter]. Under penalty of perjury, the person signing below: (1) warrants that he/she is authorized to execute this EDS recertification on behalf of the Disclosing Party, (2) warrants that all certifications and statements contained in the Disclosing Party's original EDS are true, accurate and complete as of the date furnished to the City and continue to be true, accurate and complete as ofthe date of this recertification, and (3) reaffirms its acknowledgments.
 
Urban Form Investments, LLC      Date:   [ "<=\" ZO!^>
(Print or type legal name of Disclosing Party)
 
By:
 
 
(sign here)
 
Print or type name of signatory:
 
 
 
Title of signatory:
 
Ver. 11-01-05