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eE;,gig) - 6` Certificate of Real Estate Value
<br />r. Duyer's Last Name, First, Middle Initial : ;, , , - ;_. Present Address _.. Daytime Phone Number
<br />nth `8 urban �I?evelapmer�t, Zn Ilk
<br />'8741 NE Central Ave
<br />`Blaine, '� 55434
<br />,. -.
<br />' ellerA Last Name, F" t, Middle Initial " s- Address - Daytime Phone Number
<br />J.: .and Lucille 660 79th St., Circle Fines, Mn. 55o14
<br />(.real Address or Rural Route of Property Purchased , ; I City or Towrsh+ County
<br />66Q 79th St . ,' Circle Pines , . , 55t}l4 ,��s: e z n` AIIbkB
<br />0'r Legal bescription of Property Purchased (Fill in lot number block number and plat name or attach 3 copies of the legal description) c
<br />$4.y..�.ir _'> . a
<br />rn� x�.tf,+'"-x'-
<br />�g�-`-;6,-x. � .,,�,�':: �t .x r �s _ k" x rrr�j+�.�s 'y`� ' a � �;' si �`k'f:•riK'"' `� - a aft � Y
<br />,Type of Acquisition (check aEE boxes which appfyj �_�
<br />�''k''}r'� *`
<br />-
<br />x ❑ You tied seller are relatives Erna i",; c ❑ Buyer s a rettg+ous or trr� arrt'r ` rl / s ey+yx �aat n
<br />or related businesses - charitable organization 7 /'l :sal6) Al-r
<br />'� * rt ❑; roperty is a gilt or inhentance ❑ Guyer is d unit of government a yy ly �r
<br />: d� >`, � .�-. .>; :xc$,,,.."-t-f.,J ..:i•- ,ir -��
<br />❑ You received property in a trade ❑ You condemned or forec csed is
<br />on the property L✓(.N f /� ! 3 ��
<br />_ j r:} ✓ "` ''' ,'n'T' •i s^' -i „x s
<br />If you checked any box above, skip the rest of this forrr
<br />Type of Property Transferred (check all boxes which apply}" ""r`r
<br />40 z`! -❑ rand Only t ; ,� n E �j Land and Buildings completed
<br />iaya� ✓+= s-: ti:•,;t�i�'��-
<br />,�-
<br />,.v`u
<br />Planned Use of Property (check one box)
<br />-rr#+'�J *S�` =%;'! �r't'.«ii • _�„..
<br />[:*Residential (single duplex triplex) rt,.s'"a"i.. -c.,�❑ Apartment (Number of units ).� ^ ❑ Ceb+n or Recreational
<br />'ems s ❑ Agricultural r `,❑ Commercial-lndusMal T ❑ other Use (describe below) r:, i
<br />_ ' a - (TYPis of business ,
<br />'Financia rrangements (fnstrfact(ons are or back of yellow
<br />1 Total Purchase Price c Total Amount of Personal Prop" 3 Date Serer Signed Purchase Agreement r
<br />et��7�:. ma�'s /{��yt, M00
<br />� „ (from 'stcThedule A on back of this sheet)yG; A%. {lF�s?'
<br />_r t =a7.LG 'tJITT. W ``.-. ROne b J '�/""
<br />-1 — d-f
<br />DowrtPayment 5 Po+ntsoTr Prepaid interest ?eid by Seller 8 Points or Prepaid Inteiast Paid by Buyer -
<br />J1PL.-~ None -
<br />Describe each mortgage and contract,( or deed used to purchase this property
<br />fs this a -
<br />Contract or
<br />s -Assumed Mortgage or Contract for Deed Monthly Payment for Interest Rate a-' v ; Tote( Number Date of Any Lump Sum
<br />Mortgage? - Amou'Lm at PurchaEs�e,., '- Principal
<br />„and
<br />,'Interest Qn Effect how) of Payments (Balloon) Payments
<br />Yes No Furcha-sle Money M lilimia3-
<br />,: ❑ C $162.000.00 i0 f IXiQ .00 _ _10 -- 196
<br />9 ❑ ❑
<br />to it a mortgage or contract for deed is not a variable market rate bui the terms ul payment are scheduled to change On a fixed data, fill in its ling number from above, the
<br />.month and year of the change, and what It will Change to (Or attach i copies of payment schedule): - - -
<br />Fill out schedule B on the back of this sheet to determine the amount of your deed tax
<br />J
<br />) declare Mat the information flied iqqn +hs form -is !rue, co _>, and comp!a;ehe best I my knowledge and belief. -
<br />Print or type name of Person signing inis !orm 5; a! r - - Phone Number Date
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<br />Co Sv v�LenaBldg Tot P+at—Parcel
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<br />DepartmenFof Revenue Use Only I C�
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