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APPLICATION AND ADTFDRIZATIOH FOR DMAYED PAMUNT OP TLX ON SPECIAL ASSESS EN7S FOR SENIOR CZTZZDls, W=7ZID LAWS 1974, Ci UMM 206 STATZ OF MINNESOU ) County of Ramsey ; �^ Date To: Department of Property Taxation, Ramsey County, Minnesota Z, the undersigned, declare under penalties cf perjury= That I reside at .4/4 That I as not less than '65 years of age and that the date of my birth is That I am the owner of the Property legally described as: ? 4 -�yci [)I.S f ZF 3 — ��:aT �� co �'�� AlO- .' _t'i_:l /-%_ z-/J r- - Property Identification Ho.��sT—.a 3 —p�a pD pF, '�•�9—iti/9¢ 2 Z SEE A??ACH'gNiSI s- o os—sto o� .� svii �i9e—at ♦ �� /�+'; i That as interest is the ownershipot the above property was acquired on and is as follows: • 1. Sole ownership (Enter yes, if applicable) 'mye' 2. Joint tenancy, held vith�� U ,� p �„� PRi r �/ r 3. Other undivided interest Spa y / O ^�h T TI,c m �yv,�� ► �T-- That on January 2, 79C` 1' or June 1, 19 , l �p homestead and such o— be --1 I owned and occupied the above property as 27 �P�cy g� on m a .t_— J 7 9� • i That the installments for imp rn� emeats on the special assessments duly adopted nance v�hicbe�i have T./_ i rTL O_ ./_''Q' /iof • as of 1 g den allocated against e'sub ec prop would crea a undue perso me P on my behalf and I respectfully request that pagment be delayed and that such installments be so deferred for the years 19 f�'• to 19�./,� Jrn 7 7 z %G Sign v 4 • ` Own r I, Joseph G. Chlebech , Clerk of the City of Little Canada ramsey County, State of Minnesota, do hereby c y that e application of above named, has been duly reviewed and that in accordance with e u es o o c record in said chambers was duly _. APPROVED or D&XIED as of _ 11 _0- 197_. That in accordance with approval granted, the special assessments listed below on the atfiants subject property levied for annual collection in the amounts and for the years ahoum be so deferred with interest at the annual rate shown until such time as it is deemed the applicant no longer qualities or the property loses its eligibility. Name of Assessment SAn/ / T./ - 6g No. I. Krcel No. t 53-0370-470-01 53-0370-480-01 Auditors D/p Total Yearn of Collection Interest ?lumber No. Aunt (Inclusive) Rate 0425 29 6% f F 0032 $ 229.50 0425 0032 $1,110.00 29 6% CLERKIS EUIB17- no, 1284 � KEETIti—�,-11-9-77 " tv-Lork or Authorized Deputy)"'