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Anoka County Division of Property Records & Taxation Abatement Form 7 (Rev 2/95) APPLICATION FOR ABATEMENT - SPECIAL ASSESSMENTS (M.S. 375.192) County Auditor's Number County of Anoka Applicant's Name For Taxes Assessed in 19 95 and Payable in 19 96 Please print or type. Marilyn G. Anderson Clerk -Treasurer Applicant's Social Security Number Applicant's Telephone Number ( 464 ) 5562 Date of Application March 6, 1996 Applicant's Mailing Address CITY OF LINO LAKES 1189 Main Street Lino Lakes, Mn. 55014 DESCRIPTION OF PROPERTY Property I.D. or Parcel Number 28-31-22-32-0019 Street Address (if different than above) 875 Birch Street Lino Lakes, Mn. 55014 City or Township Lino Lakes School District Number #12, Centennial LEGAL DESCRIPTION OF PROPERTY See Attached APPLICANT'S STATEMENT OF FACTS The City is requesting that the assessment for Funds 82363 and 82364 for the above described property, PIN. 28-31-22-32-0019 be abated entirely. The payment was received in full on November 9, 1995 and the assessment clerk was not notified of the payment. APPLICANT'S REQUEST Include fund number & amount due for payable tax year being abated, not total principal amount. The City is requesting that the assessment for Funds 82363 and 82364 for the above described property be abated entirely. The payment was received in full on November 9, 1995 and the assessment clerk was not notified of the payment. icantSignature i h/ q6 Date NOTE: Minnesota Statutes 1988, Section 609.41, "Whoever, in making any statement, oral or written, which is required or authorized by law to be made as a basis of imposing, reducing or abating any tax or assessment, intentionally makes any statement as to any material matter which the maker of the statement knows is false my be sentenced, unless otherwise provided by law, to imprisonment for not more than one year or to payment of a fine of not more than $3,000, or both."