Transmittal to John Chadwick 11-23-2010CITY OF CHANHASSEN
PLANNING DEPARTMENT
7700 Market Boulevard
P.O. Box 147
CHANHASSEN, MN 55317
(952) 227 -1100 FAX (952) 227 -1110
TO: Mr. John Chadwick
J. Edwin Chadwick, LLC
11430 Zion Circle
Bloomington, MN 55437
LETTER OF TRANSMITTAL
DATE JOB NO.
11/23/10 1 2010-09
ATTENTION
John Chadwick
RE:
Pioneer Pass
WE ARE SENDING YOU
®
Attached ❑
Under separate cover via the following items:
❑ Shop drawings
❑
Prints
❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter
❑
Change Order
❑ Pay Request ❑
COPIES DATE I NO. DESCRIPTION
1 11 -23 -10 1 1 Executed IRS Form 8283
THESE ARE TRANSMITTED as checked below:
❑
For approval
❑
Approved as submitted ❑ Resubmit copies for approval
®
For your use
❑
Approved as noted ❑ Submit copies for distribution
®
As requested
❑
Returned for corrections ❑ Return corrected prints
❑
For review and comment
❑
❑
FORBIDS DUE
❑
PRINTS RETURNED AFTER LOAN TO US
REMARKS John - Part II and Part III of the attached form needs signatures. Please return a copy of fully executed
document to my attention.
COPY TO:
SIGNED:
Bob Generous, Senior Planner, (952) 227 -1131
If enclosures are not as noted, kindly notify us at once.
11/17/2010 14:41 9524960057 JAMES STREEFLAND PAGE 02
Names) shown on your Income tax return identifying number
SEVERIN AND SHARON PETERSON r-
Section S. Donated Property Over $5,000 (Except Certain Publicly Traded Securities) -- List in this section only items
(or groups of similar items) for which you claimed a deduction of more than $5,000 per item or group (except contributions of certain publicly traded securities
reported in Section A). An appraisal is generally required for property listed in Section 8 (see Instructions).
Part l A Information on Do nated Property -- To be completed by the taxpayer and/or the appraiser.
4 Check the box that describes the type of property donated:
Art" (contribution of $20,000 or more) Qualified Conservation Contribution Equipment
Art" (contribution of less than $20,000) X Other Real Estate Securities
Collectibles "" Intellectual Property Other
-Art includes paintings, scuiptures, watercolors, prints, drawings, r4ranllcs, antiques, decorative arts, textiles, carpets, silver. Taro manuscripts, historical memorabilia, and other similar objects,
"Colieetibias include coins, stamps, books, gems, jewelry, sports memorabilia, dons, etc., but not art as defined above.
Note: In certain cases you must attach a uahfled a raiSal of the p See instructions.
5 (a) Description of donated property (il you neetl (b) If tan gible property was donated, give a brief summ of the (c) Approised fair
mores ace, attaCn a 9 crate statement overa`I h sicel cOnditian of the prOpert at the t me of the iR market value
A1 18 ACRES OF FARM LAND 540,004,
See Instructions
For bar ,n sales, h Amount claimed Avers (1) trading
01) Dete (8) How acquired (f) Donor's cost (J) 9° (� r S
acquired by by tlonvr or edlu$t4d haeis enter amount eecelved as a doductlon price of seeuritles
(
arious jPurchase
B
C
D
Part lI I Ta a er { D onor) Stateme — List each item included in Part I above that the appraisal identifies as having a
value Of $500 or less. See instructions,
I declare that the following itetn(s) included in Part I above has to the best of my knowledge and belief an appraised value of not more than $504 (per item).
5riter identifying letter from Part I and describe the specific item. (See instructionS).
Date P'
Signature of taxpayer (donor
Part III LDecl aration of Appraiser
I declare that f am not the donor, the donee, a party to the transaction in which the donor acquired the property employed by, or related to any
of the foregoing persons, or married to any parson who is related to any of the foregoing persons. And, if regularly used by the donor, donee,
or party to the transaction, I performed the majority of my appraisals during my tax year for other persons -
Also, I declare that I hold myself out to the public as an appraiser or perform appraisals on a regular basis; and that because of my
qualifications as described in the appraisal, I am qualified to make appraisals of the type of property being valued. I certify that th® appraise!
fees were not based on a percentage of the appraised property value. f=urthermore, I understand that a false or fraudulent overstatement of
the property value as described in the qualified a raisal or this Form 8283 may subject me to the penalty under section 6701(a) {adding and
abetting the understatement of tax liability). In addition, I understand that a substantial or gross valuation misstatement resulting from the
appraisal of the value of the property that I know, or reasonably should know, would be used In connection with a return or claim for refund,
may subject me to the penalty under section 6695A. I affirm that I have not been barred from presenting evidence or testimony by the
Office of Professional Responsibility.
Sign
Here I Signature F Title i" Data
6uslness address fincludina room or suite no,) identifying number
city or town
Part IN , Donee Acknowledgment To be completed by the charitable organization,
This charitable organization acknowledges that it is a qualified organization under section 170(c) and that it received the donated property
as described in Section i3, Part 1, above on the following date • 11/19/10
(Date)
Furthermore, this or a nization affirms that in the event it sells, exchanges, or otherwise disposes of the property described in Section B, Part I
(or any portion thereo�j within 3 years after the date of receipt, it will file Form 6282, Donee Information Return, with the RS and give the do n or
a copy of that farm. This acknowledgment does not represent agreement with the claimed fair market value.
Does the organization intend to use the ro ere for an unrelated use ? ........... . . ............ o - - • • • • - Yes X No
Name of charitable organization (donee) Employer identlflcattlon number
CITY OF CHANHASSEN
Address (number, 5veet and room or suite no.) City Of town Slate ZIP code
7700 MARKET BLVD PO BOX 147 CHANHASSEN MN_ 55317
Authorized s awre p Title Data
FDIZIB1 atn05107 Form 8283 (Rev 12 -2006)