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WASHINGTON COUNTY ASSESSMENT DIVISION <br />APPLICATION FOR A-BATEMENT - GENERAL FORM (M.s ) 375.392 <br />CLASSIFICATION / DISASTER CREDIT f SPECIAL ASSESSMENTS <br />Wut l<shect Assessment Year: 2008 <br />Payable Year: 2012 _ <br />APPLICANT <br />L wiier`s Name (please print or type') Soc, Sec. /Fed ID Phone Cell <br />Edward & Mary Lenth � � <br />Owner's Name Soc. Sec. /Fed ID[ Phone Cell <br />O«ner s l�az� c Soc. Sec. rF'ed 1D Phone Cell <br />Owner's Mailing Address Property Address (if different from mailing address) <br />2141 legion lane N ___... <br />City State i Lip City State Zip <br />Lake Elmo MN 55042 1 j <br />DRSC112TP']r'ION OF PTROPFRT"Y <br />Property ID Number <br />MP Number <br />24.029.21.43.0008 <br />Legal Description of Property <br />City or Township <br />School District # <br />TAG <br />Eden Park Lot 17 dock 2 Subdivision Cd 37180 <br />Lake Elmo <br />834 <br />ASSESSOR'S ESTIMATED lE'; ARKET VALUE <br />Original: <br />Land FMV Improvement EMV Total Classification <br />Revised: <br />Land EMV j Improvement EMV Total Classification <br />Applicant's Statement of Facts, <br />Applicant's Request, <br />Please abate the 2009 Street Improvement assessment to the amount of $1575. This was paid by the taxpayer in July 2011 <br />Taxpayer should not be assessed for this improvement in the future <br />Applicant's ,Signature: Ott ter � �� � 1 i � <br />_.__... .........._.� .._... —_ <br />Mote: Minnesota Statute's 1988, Section 609.41, "Whoever, in thaking any statement, oral or written, which is required or authorized by <br />law to be made as a basis of imposing, 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 payrneuit of a fine of not more than $3,000,00 or both. <br />Note. Must include City/Township Resolution for reductions on assessments <br />Note: Must include f=ire report for Local Option Disaster Credit <br />I Rev 5/10 <br />