Declaration of Restrictive CovenantsDocument Number: A7260,64
Filed and/or Recorded on
lun 2, 2021 8:36 AM
Office of the County Recorder/Registrar of Tiues
Carver County, Minnesota
Kaaren Lewb, County Recorder
Deputy KL
Document RecordirE Fees $ 46.00
Docunr€ ttIotr, $ 46.m
Requesting Party: Executirr€ TiHe - Laura Kmwhs
Pages: 18
DECLARATION OF RESTRICTIVE COVf,NANTS
TIIIS DECLARATION OF RESTRICTTVB COVENANTS, dated this {aay or/7^2021 (the "Declaration"), by Lakes at Chanhassen, LLC,a Minnesota limited
liabili4 company (the "Davelope/'), is given for the benefit of the Chanhassen Ecqromic
Developmat Aufiority, a public body corporate and politio under the laws of Mnnesota (tlre
'EDA).
RECITALS
WHEREAS,
Development, dated
tIe A and dt Developer entered into 6at c€rtain Contract for Private
2021, (the *Agreemenr"
); and
WHEREAS, pursuant to the Agrccmcnt tie Developo is obligated to cause constuction of
I lO-unit three-story scnior apartment building and all relaed amenities and improvements (the
1P.jot'l) to b€ located on the property described in Exhibit A atached hereto (the "Development
Property"), and to cause cornpliance with certain affordability covenans descxibed in Section 4.5 of
the Agreemeng and
WIIEREAS, Sectiot 4.5 of the Agreement rcquires that the Dwelop€r cause to be execured
an insrument in recondable form sub*antially reflecting the covenants set forth in that section ofthe
Agreement; and
WIIERIAS, the Devdoper intends, declares, and covanants that tbe resuictive covenants set
forth herein will be and are covenmts running with dre Dcvelopment Property for the term described
herein and binding upon all subsequent owners oftbe Dwelopmert Property for tk term described
hqein, and are not merely po'rcnal covenants of the Dwdoper; and
WHEREAS, capitalized terms in 0ris Declaration have the meaning prwided in the
Agreement unless ottrenwi se defined herein.
I
CHl35-62-722576.v!
NOW, TIIEREFORE, in consideration of the promises and covenants hereinafter set forth,
and of other valuable considcratioq the receipt and *rfficiency ofwhich i s hoeby acknowledged, dre
Developer agrees as follows:
l. Term ofRestrictions
(a) Oco.rpancJ and Rental Resriaions, The term of the Occr.rpanry Restrictions set forttr
in Section 3 ofthis Declaration will commence on dre date a certificate of occupancy is received from
the City lor all Rental Housing Units on the Dwelopment Property and continue through the
Declaration Termination Date defined below (the "Qualified Prqiect Period).
(b) Termination of Declaration. This Declaration shall terminate upon the earlier of (i)
the date the TIF Dstrict is terminated in accadance with the TIF Act or (ii) the date (A) the Note is
paid in firll or the EDA cancels the Note upon a written request for termination by the Developer and
(B) the EDA detemines, in its sole discraion, ttra such termindion will not limit or interfere with
the EDA's ability to pool Tax Increment generated within the TIF District for atrordable horsing in
accordance with the TIF Act.
In addition, in the event offoreclosure or transfer of tide by deed in liar of foreclosurg upon
completion of the foreclosurc and expiration of the applicable mortgagee redemption penod, or
recording ofa deed in lieu of foreclmure, any mongagee (or any assignee of the mo4gagee) or any
purchasers at or after foneclozure thermf, by the s.lccessftl bidder at the salg to the title to the
Dwelopment Property, mEy tenninate this Dedaration, by providing written notice to the EDA and
by filing a termination document in the applicable real propsty records in Carver County, and
thereafter this Declaruion shall be of no furlher force and effect providd however, that fte
prmeding provisions of this sentence shall cease to apply and the restictions contained hcrcin shall
be reincated if, ar any time subsequent to the termination of this Declaration as the result of the
foreclosure, or the delivery ofa deed in lieu of foreclosure, or a similar evenl lhe Develcpa or any
relatcd pcrson (within thc meaning of Scction 1.103-I0(e) of the Treas:ry Regulations) obtains an
ownership interest in the Prcject for federal incorre ta,r prposes.
Each of the events set forft in the first two paragra.phs of this Section 1@) are refened to
individually and collectively herein as the "Dcclaration Tsmination Darc-" The Dwdoper
acknowledges, on behalf of itself and its slcc€ssors and assigns that, upon any termination of this
Declaration prior to the payment in full of the Note, the EDA will terminate the Note.
(c) Rernoval from Real Estate Records. After the Declaration Termination Date of this
Declaration, the EDA will, upon request by the Developer or its assigns, file any doomot
appropriate to rernove this Declaration from the real estate records of Carver Cormty, Mnnescta.
(;) All leases of Rental Housing Units o Qualiging Tenans (as definod in
Section 3(a) hermf) will corrain clauses, among others, wherein each individuat lessee:
2
2. ProiectRestrictions.
(a) The Dweloper represents, warants, and covenants that:
CHIIJ-62-7225?6.1/1
(l) Certifies the aco.nrcy dthe statE nents made in its application and
Eligibility C€rtificoiar (as defined in Sccrion 3@) hermf); and
@ Agrees dru fre family incane at the time the lease is executed will be
deened a substantial and mat€rial obligation of tbe less€e's tenrncy; tlat the lessee
will comply prdnpfly with all rrque*s for incme rnd odrer infrmation rela/ant to
detamining low or moderate income statrs from the Devetoper o( the EDA and tlut
the lessee's failure or refi.rsal to comply with a request f6 informarion with res@
thereo will be deerned a violatior of a sr$suntial oblig*ior ofthe lessee's tenancy.
(b) The Developer will pe'mit any duly authorized representative of the EDA to inspect
the books and records of the Developer pertaining to the income of QualiSing Tenants residing in
the Project.
3. Occupancy Resfictions. Ile Devdoper represer[s, warr8trb, and covenants that:
(a) Gplifying T€nanrs. Ttrurghort 6e Qualified prcject perio( (i) all of the Rental
Horsing Units shall be occupied by at least one penon q o is at least 55 years of age at the time
of initial occuPancy and shall be otherwise administered in accordance with 42 USC Section
3607(b) ord Mnnesota Statutcs, Sccrioo 363A.21, subdivisior 2; and (ii) at least 50 (44yo)o/o of dte
Rental Hosing Unia $all be ocotpied (or trered as ocarpied as provided herein) or held vacant and
available for occupancy by Quali&ing Tenants. "Quali$ing Tenants' means thce persqrs and
families who are determined from time to time by the Devdoper to have combined adjusrcd income
that does nd exceed 60lo of the median income for tre sEndard mero,politan $atistical area which
includes chanhassan, Minnesot4 as that figure is deermined ard amormced fron time to time by
HUD, as adjusted for family size (the "Median Income") for the applioble calendar year, For
purposes of fris definition" the occupants of a Rental Housing unit will not be de€nred lo be
Quli&ing Tenurb if all the ocorpants of srch Renul Horsing unit at any timc are "studeots,' as
defined in Section 152(f(2) of dre Intemal Revenue Code of 1986, as amended (the.,Code',), not
qrtidcd to an eremption under the Code. The determination of whether an individual a family is of
Iow or moderate income will be made al the time the enancy commemces and on ur ongoing basis
theresfter, det€rrnined at least annually. If during rheir tenancy a Quali$ing Tenart's incorne o<ceods
140lo ofthe lvledian Incomg the ntxt available Rental Hqrsing Unit (daermined in accordance with
the code and applicable regularions) (the *Next Available unit Rule") must be lessed to a euslifying
Tenant or held vacsnt 8nd svdlable for occupancy by a euali&ing Tenant. If the No.t Available
unit Rule is violated, the Rental Horsing unit will not continue to be reated as a er.rali&ing unit.
(b) Certificetiofl ofTeoant Eligibiliu. As a conditim to initial and continuing occupancy,
each person who is intended to be a Qualiling Tenant will be required arunrally to sign End delivcr
to the Developer a Certification of Tenant Eligibility substantially in the form atached as Exhibit B
hoeto, or in any other frrrn as may be approved by tre EDA (fie'Eligibility catificaior"), in which
the prospeclive Quali&ing Tenant certifies as to haring a quali&ing low or moderate income. ln
addition, at leas one person in each Rental Horsing unit shall certi& as to being 55 years of age or
older. The Qualifuing Tenant will be required to provide whatever other information, documentq r
3
cHr3542-172516.\tl
csrtifications Ere d€emed neoe$sa5r by the EDA to sub$antiate the Eligibitity Certifioaion, on an
ongoing annual basis, and to veri$ that the temnt mntinues to be a Qualifring Tenant within the
meaning of Section 3(a) hereof Eligibility Certifications will be maintained fortre durarion of tie
Qualified Pmj ect Poiod or 6le by the Developer with resp€ct to each QualiSing Tenart who resides
in a Renal Housing Unit or resided therein during fie Qualifiod Prc{act Period.
(c) I*ap. The form of lease to be utilizod I the Dareloper in rcrting any Rortal
Hcrsing Unie in the Proj ecr to any penon who is inlemded to be a Qualifing Tenant will provide for
termination of the lease and mrxent by the persor to immediate eviction for frilure to quali! as a
Quali$ing Tenant as a resuh of any material misrepresentation made by the puson with respect to
the Eligibility Certification. The Developer coveoane and agrees that during the Qualiffed Project
Period it will not incrEase 0te rEat charged to any tenant of a Rental Hdrsing Unit within the Project
during such tenant's lease term and, at any rug will not increase tfie rent charged to any tenant more
than onoe in any 6-month period.
(d) Annuel Report The Dsreloper covenants and agees that during the term of this
Declaratiog it will prepare and submit to the EDA on or befue July I of each year, a ccrtificatc
substantially in the form ofExhibit C arached heretq o<ecuted by the Dweloper, (a) identiSing dre
tenancies and the dates ofoccrpancy (or vacancy) fo all Quali$ing Tenants in the Projecl including
the number and perrentage of the Remtal Housing Units of the Prdect which wcrc occupied by
QualiSing Tenans (or held vacant and available for oosupatrcy by Quali&ine Tenaots) u all times
dtning the year preceding tle date of the certificate; @) desoibing all transfers or otha changes in
ownership of the Project or any interest therein; and (c) stating, that to the best knowledge of the
person exeorting the certificate after due inquiry, all the Rental Housing Units were rented or
available for rental on a continuors basis dwing dre year to members ofthe general public and that
the Devdoper was nc otherwise in default under this Declaration during the year.
(e) Notice ofNon{omgliance. The Devdoper will immediately noti} the EDA if at any
time during the term of this Declaration fewer than 50 (44o/of/o of the Rcntal Horsing Units in the
Project are ocorpied or available for occupancy as required by the terms ofthis Declaration.
4. Transfer Resrrictions. The Developer @venanls and agres thaf the D€veloper will
cause or require as a condition prec€deot to Eny cdrveyanc€, transfer, assignmen! u aoy otho
disposition of the Project prior to the terrnirntion of the Occupancy Re*rictions provided herein (ttre
"Iransfer") that the ransferee ofthe Prdect prus.larrt o the Transfer assume in writing in a form
acceptable to the EDA, all duties and obligaticrs ofthe Developer under this Declararioq including
this Secrion 4, in the went ofa subsequenl Transfer by the transferee prior to expiration oftre Rartal
Resrictions and Ocorpancy Restrictioas provided herein (the "Assrrnption Agreemenf'). The
Developer will ddiver the Assunption Agrernent to the EDA prior to the Trander.
5. Enfoccrnent
(a) The Developer will permit during normal business huus and upon reasonable notice,
any duly authorized rcprcsentative ofhc EDA to inspect any boola and reoords of thc De'/eloper
regarding the Prri ect with respect to the incones of Qualifuing Tenants.
4
cHl35-62-722576.v1
(c) The Dweloper aclorowledges thal the primary purpose for reguiring conpliance by
the DeveloP€r with the resricions provided in this Declaration is to ensre compliance of the propertyy6 t",nqryrng affordability coveoants set forth in Section 4.5 of the Agreement, and by reason
thereof, the Deryeloper, in considcration for assi *ance prwidcd by tre mA under the Agrec6ent that
makcs possible the constructicn of the Prcject (as defined in tlre fureement) on the Dwelopment
Property, hereby agrees and consents frat the EDA witl be entitled" for any breach of the provisiors
of this Declaration, and in addition to all odrer remedies provided by law or in equity, to enforce
specific perfonnance by the Dwcloper of its obligaiom under this Declaration in a stats court of
competenr j urisdiaion. The Devdqer hereby further specifically acknowledges fiat the EDA camot
be adequately compensated by monetary damages in the went of any ddault hercunder.
(d) The Developer undersunds and acknowledges that, in addition to any remedy sa fonh
herein for failure to comply with 0re restrictio.ls s€t f6th in this Declardion. the EDA may exercise
any re<nedy available to it under Article MII of the Agroement.
6. Indemnificaion The Developo.herely indemnifies, and agrees to def,end and hdd
hannless, the EDA frsn and against all liabilities, losses, damageq cosB, expenses (ncluding
atlorneys' fees and openses), causes ofaction, s.rits, allegations, claims, dqnands, and judgmerts oi
any nan[e arising from lhc consequenoes ofa legal or administrdive proceeding or aaion bnrught
again* thun, or any of ther4 oo account of any failrre by the Devdoper to conply with $e termJof
this Declaratioq or on ac{,oml of any represantation or warranty of the Devdoper mnrained herein
being unrue.
7. Agent of the EDA. The EDA will have dre right to appcint atr agerrt to oany qrt ary
of its &.rties and obligations herannder, and will irtrorm the Developer ofrny agency appointmenl by
wdtten notice.
O) The Developer will zubmit any other information, dcuments or cenifications
requestod by tle EDA wltich the EDA deems reascnably necessary to srbstantiate the Doreloper's
continuing complience witfi the provisions specified in this Declaratiqr.
8. Severability. The invalidity of any clause, part or prwisian of this Declaration will
nd affea the validrty of the remaining portiors draeof.
9. Notices. All noticcs to be given puruant to fris Declaration must be in writing and
will be deemed given when mailed by certified or regisrered mail, retrm receipt requestd to the
parties hereto at the addresses set fortr below, or to ury other place as a party may from time to time
designate in writing. The Developer aod thc EDA may, by notice givcn hera:nder, desipac any
further or different addresses to which zubsequent notices, certificates, or cthrr communicdions are
sent. The initial addresses for notices and dher communications are as follows:
To the EDA.Chuhassen Eoonomic Dorelopment Authority
7700 Market BoulevE d
Chrnhassen, MN 55317
Attn: Executive Director
5
cHlSr{2-722 J76.Yl
and with a ct)py to:Kennedy & Graven, Chartered
150 SouthFifth Strea
Suite 7oo
Minneapolis, MN 5 5t102
Attn: Ronald H. Bany
To the Dweloper Lakes at Chanhassen, LLC
350 Highway 7, Suite 218
Excelsior, MN 55331
Atn: Todd M. Simning
10. Governinq Law. This Declaration is governed by the laws of the State of Mnnesota
and, where applicablg the laws of the United States of America.
11. Anomeys' Feqs. [n case any action at Iew or in equity, includirrg an actioo for
declaratory reli{ is brorght against the Developer to enforce the provisons of this Declaration, the
Dwelopet agrees to pay the reasonable atorneys' fecs and chcr rcasonable ocpeoses paid or incurred
by the EDA in connection with drc action
12. Dec,laration Binding. This Declaruion and the covenants coatained herein will nm
with the Development Property and will bind the Developer and is successors and assigns and all
subsequenl onners ofthe Development Property o( any interest therei4 and the benefits will inure to
the EDA and its zuccessqs and assigns until the Declaruion Termination Due of this Declaraisr as
provided in Section t(b) heroof.
6
CHl35-62-7225 16.v|
IN WITMSS WHEREOF, the Dweloper has caused this Declaratinn of
Covenants to be signed by its respective duly authorized representatives, as of the day and
written above.
LAKES AT CHANHASSEN, LLC
By:K
ve
Todd M. Simning, Manager
STATE OF MINNESOTA
COI]NTY OF
liability company, on behalfofthe gompany.
THIS INSTRTJMENT WAS DRATTEDBY:
Kennedy & Graven, Chartered @IIB)
150 Sorlth Fifth Sreet
Suite 700
Minneapoliq MN 55402
(6r2) 137-9300
)
)
)
SS,
The foregoing instrument was acknowledged before me ttri.2 74ay ot fl.t
2021, by Todd M. Simning, the Manager of Lales at Chanh'sse;, LLC, ; Mffi# ltrntGi
Notary Public
7
ffi ERICANDREW WHITEIS
NOIARY PT'ISLIC
UINNESOIA
rrr Corfirltl Elir.Ja 3r.2@6
CH13162-7?2576.v1
CHANHASSEN ECONOMIC DEVELOPMENI
AUTIIOR]TY
Its Executive Director
Noury
KIM T.MEUWISSEN
Notary Plrbilc-ffln l€sol8
rrry odfnfdt E{ara Ja 3!.2045
President
By
Its
By
\
8
CH115-62-722516.\'l
This Declaration is acknowledged and consented to by:
srArE oF MTNNESOTA )
couNrYoF Gr'''r I
tt
The foregg.i.ng instrument w-as-acknowledged before me *r45*, of {Yhr /
zozr,bvf lceREtnanaffi fqgg$e"PresidentandExecnlffi t;Jo.:ilp*'-ffi .ty,;
the Chanhassen Eccircmic Developnent Authority, a public body corporste and politic under the
laws of Minnesot4 on behalf of the EDA.
Erhibit A to Dcclaretion of Rcstrktive Covemntr
Description
The land subject to th€ foregoing Restrictivc covenants is legally described as follows:
Lot 2, Block l, Powers Ridge Apartment Homes 2d Addition, Carvet County,
Minnesota.
CHl35-6L122576.v1
A-1
Ethibit B to Declaration of Resrictive Covenants
Certifi cation of Tensnt Eligibility
TENANT INCOME CERTT1ICATION
E Initial cenificetion fl Recenificmion E ottrr
Effective Date
Mov€-tu Date:
(MM/DDrrY)
PART L DEVELOPMENT DATA
Property Name:
Senior Apaltments
Ad&ess:
ChanhasseL MiffEsota
BIN #:
# Bedmoms
PART IL EOUSEEOLD COMPOSITION
IIH
Br#last Name
FLst Name &
Miildte Initial
Relationship to
Head of
Housebold
Date of Binh
@rvI/DD,ryY)
F/T Student
(Y or N)
Socisl S€cudty
or Alien Reg.
No-
I
2
3
4
5
6
PART II1. GROSS ANNUAL INCOME (USE A}INUAL AMOUNTS)
HH
Br#
(A)
Euploynrnt or Wages
(B)
Soc. Security / Pensions
(c)
hlb Assista-Dce
(D)
Other lncorrc
TOTAL $S $
Add lotals fiom (A) thmugh (D) above TOTAI INCOME (E):$
CHl35-6?.122316.\tt
B-l
Coutrty:
Cary€r
Udt Nunb€r: _
FIEAD
$
PART IV. INCOME FROM ASSETS
(F)
Typc of Assct
(G)
at
(H)
Cash Value of Asset
G)
A-nnual Incomc fmm Asset
TOTALS:s $
$
Passbook Rae
x 2.00Y. = (Dlryutedlmmc
E&r thc gtEder of tlE roral colwu I or I: iryur€d inconE TUIAL INCOME FROM ASSETS K)
ifover $5,0@ $
E ter Colulul (H) Total
s
(l) Tml Aruual Household Incoc from all souc€s [Add (E) + (K)]$
III
EOUSEEOLD CERTINCATION & SIGNATI]RES
The informalion on tlds form will be used to deEnnine nraximum ircome eligibility. Uwe haw provirtcd for erh
PersonG) set font in Part tr acceptable verificadotr of c1lltEm 4ricipatcd annul ircofie. Uwe agree to notif the
lardlord imrnediately upon any menrberofthe busehold moving out ofthe unit or any rew member moving in. Uwe
agrce to mtit tbe ladlord inmediatety upoo ary ncmber bccoming a fitll-time student.
Under pernftix of pe{ury, Ilre cutiS 0rat t}E idoroatbn g€senlod ir rrris Certificalbn is lnE 8rd acculae to t]hs
bes ofmy/orr trowledge ad telief. The un&lsigned frrtbr understads thd poviding false nprcsent*ions haein
co,rslitulcs an 8d of Aaud- False mislcding or ircorpbtc idormdiotr may rEsult in thc tcrmimtion of the l€as:e
agreerE![.
(Dare)Signatu€(Date)
Signaturc (Dare)Signatue (Date)
TOTAL ANNUAL HOUSEHOLD
INCOME FROM ALL SOURCES
Frcm ltem (L) on pagE I
Household tvleets
lrrcone Resriction
al:lot fisvtI wto Etoyotrvo
RECERTMCANON ONLY
CrErent IrEorre Limit x l40zo
$
Current Ircome Limit per Family Sizc : $
Houshold Lrolle d Movs,in
$
Housebld ieorE oa€eds l,loPlo
rcccnifrcation:
EYes Exo
s
Household Size at Move-in:
CHl35-62-122576-\1r
B-2
ItH
Mbr#
Sign tue
PART V. DETERMINATION OF INCOME ELIGIBILI'T'Y
PART VI. RENT
Not Applicable
SIGNATURI OT
OWNER/
R-EPRESENTAITVE
Based on the rcprese ations horEin and upon th€ proofs and documentation rcquircd to be srbmine4 the
idn'idual(s) mrcd in hn tr of this Tenafl. Ircotre Certifica.ion is/arE eligible uder tE prcvisions of Setion 42
of tlre Interral ReveDue Code. as ametrded- and the Reguhtory Agteetn6 (ifapplic$le), to liw in a unit in this
PrDject.
SIGNATURE OT OWNER / REPRESENTATIVE DATE
PART VII. STUDENT STATI]S
Eoter
1.4
Dyes E m
ARE ALL OCCIJPANTS FTILL.TIME
STI.'DENIS?
Ifyes, enter sird€r( explanation* *
(also atlach doc'uncnlation)
Mak thc pmgram(s) listed beloe (a. tbrough e.) for which tbis housebold's unit will be coutrt€d towad the properry's occupancl'
r€quirEmerxs. Utder each pmgram mart€d, indicalc thc household's irorne suus as cstdlished by this certification/recertifrcation
SeE Pan V above. Inconv Status Inome Status Incomc Stohts Income Stotus
E s sryoauct tr 50plo AMGr E < 509/oAMcr trE s oryznaucr tr 6v/o N.iGt E s rcgroeuct trE s acz".qlrrcr tr Eop/o AMGI E =
o, ** E =
o, .*
E =
or** tr olr*
'* Upon rccenification, household was detemirEd over incotE (OD rccoding to etigibiEty rcquirEtrEr s of th ptogram(s) ou*ed
above.
e.tr
(Name of Pmgram)
a. Tax crEdir E b- HoME E c. Tor Iixanp I d AHDP E
cRl35 42-122316.\/t
B-3
Stdent explsnation:
l. TANF sssistancc
2. JS trainiqg pmglam
3. Single po ent/dependenl child
a. Manied{oint rau{
PART VIIL PROGRAM TYPE
This form is t<t be c<nnpleted by the an ner or an autho zed representative.
PertI-DevdopmentDeta
check the appropriate box for Initial certificatioo (move-in), Recertification (annual
recertification), or other- Ifotheq designate the purpose ofthe recertification (.e., a unit transfer,
a change in household compositio4 or other state-required recertification).
Move-in Date Enter the date the te-nEnt has or will take occupancy of the unit.
Effective Date Enter the effective date ofthe certification. For move-i4 this should be the
move-in date. For annual recertification, this effective date should be no
later than one year from the effective date ofthe previotrs (re)certification.
Property Name
County
BIN#
Address
Unit Number
Head of household
Adult co-tenant
child
Live-in caraaker
Enter the name ofthe developmcnt.
Etrter the cornty (or equivalent) in which the building is located.
Enter the Building Identification Number @IN) assiped to the building(frm IRS Form 8609).
Enter the street address.
Enter the unit number.
Enler the number of bedrmms in the unit.
Part II - Eoueehold Composition
List all occupants of the unit. stste each household mernber's rclationship o the head of the
household by using one ofthe following coded definitions:
H
A
C
L
Spouse
Other family member
Fostcr child
None ofthe above
Ent€r the date ofbirth, student status, and Social Security number or alien registration number for
each occupant.
If there are more than seven @cupnnts, use on additiorul sheet of ryer lo list the rcmaining
lnusehold members otd attach it to the certifcation.
CB 135{2-722576.i1
B-4
INSTRUCTIONS TOR COMPLETING
TENANT INCOMf, CERTItrICATION
# Bedrooms
s
o
F
N
Part III - Annual Income
See HUD Handbook 4350.3 for complete instruotions on verifring and calculating income,
including acceptable forms of verification.
From the third party verification forms obtained from each income source, enter the gross amount
anticipated to be received for the 12 months from the effective date of the (relertilication.
Complete a separate line for each income-eaming member. List the respective household member
number from Part II.
Column (A)Enter the annual amornt ofwages, salaries, tips, commissions, bonuses, and
other income from employment; distributed profits and/or net income from
a business.
Column (B)Enter the annual amount of Social Security, Supplemental Security lncome,
pensions, military retirement, etc.
Column (C)Enter the annual amount of income received from public assistance (i.e-,
TANF, general assistance, disability, etc.)
Column @)Enter the annual arnount of alimony, child suppor! unemployment benefits,
or any other income regularly received by the household.
Row (E)Add the toals from columns (A) through (D) above. Enter this amount
Part IV - lncome from Assets
See HUD lfuldbook 4350.3 for complete instsuctions on veri$ing and calculating income from
assets, including acceptable forms of verification.
From the third party verification forms obtained from each asset source, list the gross amount
lnticipated to be received during the 12 months from the effective date of the certification. List
the respective household mernber number from Part II and complete a separate line for each
member.
Column (F)
Column(G)
List the type of asset (i.e., checking accounq savings aocount, etc.)
Enter C (for current, if the family curreDtly owns or holds the asset), or I
(for imputed, if the family has disposed of the asset for less than fair market
value within nso years of thc effective date of (re)certification).
Column (H)
Column (t)
Enter the cash value ofthe respective asset.
Enter the anticipated annual incomc from the asset (i.e., savings account
balance multiplied by the annual interest rate).
CHl35-62-722576.i1
B-5
TOTALS Add the total of Column (II) and Column @, respectively.
If the total in column (H) is greater than $5,000, you must do an imputed calculation of asset
income. Enter the Total Caeh Value, multiply by 2% and enter the amount in (J), Imputed Income.
Row (K) Enter the Greater of the total in Column (I) or (J)
Row (L) Total Annual Ho:sehold hcomc from All Sources Add (E) and (K) and
entcr the total
cEt35-6L't2?516.\!t
B-6
Exhibit C to Decleration ofRestrictive Covenants
Certificate of
Continuing Progra.m Compliance
The following information with respect to the Prcject locat€d at
Chanhassen, Minnesoa (the "Proje6"), is being provided by Lakes at Chanhassen, LLC (the
"Owner") to the Chanhassen Economic Development Authority (the 'EDA '), pursuant to that certain
Declaration of Resricdve Covenants, dated the _ day of
"Declaration"), with resp€ct to the Prciect:
2021 (the
(A) The total number of Rental Housing Units which are available for ocqpatrcy
is 1 10. The total number ofthese units occupied is
(C) The following Rental Hursing Units which are included in (B) above, have
been re-designated as Rental Housing Unis for Quali$ing Taunts since
20.----.- the date on which the last "Certificae of Continuing Program Compliance" was filed
with the EDA by the Owner:
Unit
Number
Previors Desigration
of Unit (if any)
Replacing
Unit Number
CHll5-62-722576.v1
c-l
Date:
(B) The following Rental Hatsing Units (identified by unit number) are curredy
occupied by "Quali$ing Tenants" as the lerm is defined in the Declaration (for a total of 50
units):
Small onc bcdrosn
One bedroorn
One bedroom plus den
Two bedroom
Two bedroom plus den
(D) The following Rental Horsing Units are considered to be ocorpied by
'Quali&ing Tenants", as the term is defined in the Declaration based oo the information set
forth below (for a total ofat least 50 units):
[expand to cover 99 units for Quali$ing Tenants]
Attached hereto is the most receirt "Certification ofTenart
in @) above who signed such a Certificaiqr since
(E) The Owner has obtained a "Certificuion of Tenant Eligibility,,' in the form
prwided as Exhibit B to the Declaratiorl from each Tenanl namod in @) above, and eaoh
zuch certificate is being mainaincd by the owner in its records with rcsped to the project.
each Tenant named
20-----..- the date ur
Unit
Number
list
Name of
Tenam
Number
of
Persons
Residing
in the
Unit
Number
of
Bedlooms
Tel
Adjusted
Gross
hcome
Dae of
Initial
Occupancy
Age
DE
Vacarcd and
Hold for
QualifyurC
Tenants, if
I
2
3
4
5
6
7
E
9
l0
ll
t2
l4
l5
16
t7
IE
I9
20
21
22
23
24
25
lo
27
28
29
30
IIIIII -
rI I-IIII
Ir IIII
I II I-
I
I-
III
IIII
-E
I rIIII
I IrII II
r--I-I-II
-
II
-
III-
CH135.62.722576.v1
c-2
Eligibility" for
l3
I
I
i
I
f tt
f T_-----
=H
=-
which the last "Certificate of Continuing Program Compliance" was filed with the EDA by
the Owner.
(F) In renting the Rental Housing Unis in the Prcjec! the Owner has not gven
preference to any particular group or class of persons (o<cept for persons who galiff as
Qualifring Tenants and persons meetng the minimum age restrictiors); and none of the units
listcd in @) above has boen rented for occupanry entirely by studens, no one of which is
entitled to file ajoint retum for federal income tax purposes. All of the Rental Housing Units
in the Project have been rerted purstant to a written lease, and the tsm of each lease is at
least 12 months.
(G) The information provided in this "C€rtificate of Continuing Program
Compliance" is accurate and complete, and no matters have come to the attentio*r of the
Owner which wurld indicate that any of the information provided hercir1 or in any
"Certification ofTenant Eligibility" obtained from the Tenants named herein, is inaccurate or
incomplete in any respect.
GI) The Project is in continuing compliance with the Declaration
0) At least one p€rson in each Rental Housing Unit c€rtified as to being 55 years
of age or older.
(I) The Owner oertifies that as of the date h6eof at lease 50 (44o/of/o of he
residential dwelling units in tlre Projeo are occupied or held open for ocanpancy by
Qualifying Tenants, as defined and provided in the Declaration.
(K) The Project is in continuing compliance with the Declarcion
IN WITNESS WHEREOF, I have hereunto affixed my sigraturc, on behalf of the Owner, on
,20-.
CH135.6L722516.\t
c-3
By
Its:
LAKES AT CEANHASSEN, LLC