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WASHINGTON COUNTY ASSESSMENT DIVISION <br />APPLICATION FOR ABATEMENT - GENERAL FORM W S) 375 192 <br />CLASSIFICATION 1 DISASTER CREDIT/ SPECIAL ASSESSMENTS <br />"lorksheet #: Assessment Year: <br />Payable Year: <br />APPLICANT <br />i)tivncr's Name (please print or rvue) Soc. Sec. 1}re6 ID Phone E Cell <br />Peter Klopp <br />C?wtrer's Name Soc. Sec. T -ed ID Phone Cell <br />Michael Klapp <br />i <br />-- __..._.._..m_... ...�.. .. — - u_....._....w _w,.... ........ ,......._._ _._. <br />Owner's Name - Sac. Sec. Il ed li? Phone Cell <br />Owner's Mailing Address Property Address (if different from mailing address) <br />9090 Jamaca Court <br />City Slate Zip City I State Zip <br />Lake Elmo MN 55042 <br />DESCRIPTION OF PROPERTY <br />Property Iia Number <br />?VIP Number <br />9 5.029.21.32,0018 <br />_ <br />_ <br />Legal Description of Property <br />City or Township ? School District # TAG <br />Friedrich Heights Lot 4 Block 1 Subdivision Cd 37245 <br />� Lake Emo ;' 834 <br />aIt <br />Revised <br />ASSESSOR'S ESTIMATED MARKET VALUE <br />Land wv Improvement EMV Total Classification <br />Land EMV Improvement EMV Total Classification <br />Applicant's ,Statement of Facts: <br />Applicant's Request: <br />Please abate the 2006 Overlay Pro)ect assessment in the amount of $276.85 This was paid by the taxpayer in September 2019. <br />A rplicant"s Signature: ( GLi f R K- Date- L/ r � L) <br />Note: Minnesota Statute's I988, Section 609.4I, `:Whoever, in making any statement, oral or wri€ten, 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 maybe sentenced, unless otherwise provided bylaw, to imprisonment for not more <br />than one year or to payment of a fine of not more than $3,000.00 or both. <br />Nater Must include City/Township Resolution for reductions on assessments <br />Note: Must include Fire report for Local Option Disaster Credit <br />Rev 5/247 <br />