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WASHINGTON COUNTY ASSESSMENT DIVISION <br />APPLICATION FOR ABATEMENT- GENERAL FORM lu s l375.11;2 <br />CLASSIFICATION / DISASTER CREDITI SPECIAL ASSESSMENTS <br />V4'urksheet ##; Assessment Year; 2011 <br />Payable Year: 2012 <br />Owners Name (pieasc print or tyle) SGc:. See. /Fed 10 Phone Cell <br />John Francis & Maureen Tumulty <br />Owner'sa ne Soc. Sec. /Fed ID _Phone u Cell <br />0 ane; s Vane Sac. Sec. /Fed 117 Phone Cell <br />C?wner s Mailing Address Property Address (il-differew From mailing address) <br />11933 215; Street hi <br />City __ State Zip Cary - Stale Zip <br />i <br />Lake Elmo MN 55042 <br />DESCRIPTION OF PROPERTY <br />Property ID'Number MP Nt tuber <br />24.029.21.44.0015 <br />Legal Description of Property _ _ I City or Township School District i# 3 TAG <br />Eden Park 2no Add Lot 8 Black 1 Subdivision Cd 37181 lake Elmo 834 <br />ASSESSOR'S ESTIMATED MARKET VALUE <br />Original: <br />Land EMV Improvement EMV Total Classifieatian <br />.evised <br />Land EMV Improvement EMV Total Classification <br />Applicant's Statement of Facts: <br />Applicant's Request: <br />Please abate the 2009 Street Improvement assessment in the amount of $1980.00. This amount was paid bar the taxpayer in February 2011. <br />Taxpayer_should not be assessed far this Improvement in the Future. <br />Ap aficant's Signature: ��C�� / �� Bate: <br />Note, Minnesota Statute's 1988, Section 609,41, "Whoever, in making any statement, oral or written, which is required or authorized by <br />law to be made as a basis of irnpasittg, reducing, or abating any tax or assessment, intentionally makes any statement as to any material <br />matter which the maker of the statement knows is false may be sentenced, unless otherwise provided by law, to imprisonment for not more <br />than one year or to payment of a fine of not more than $3,00000 or both. <br />?Vote: Must include. City/Township Resolution for reductions on assessments <br />]Vote: Must include Fire report for Local Option Disaster Credit <br />I Rev 5/IO <br />