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WASHINGTON COUNTY ASSESSMENT DIVISION <br />APPLICATION FOR ABATEMENT - GENE", FORM tM.S.1375.192 <br />CLASSIFICATION / DISASTER CREDIT / SPECIAL ASSESSMENTS <br />Worksheet t#': Assessment Year: <br />Payable Year: 2092 <br />APPLICANT <br />Owner's Name (Piease print or type) Sec, See /Fed tl.) Phone Cell <br />Patrick & Margaret Corrigan � � Soc. Sec IFed 113 4C - Phfln <br />Owner s 1 ame <br />Cell <br />! I <br />..__._.. <br />O��mer s'asrle Soc, Sec. /Fed lI) -- Phone Cell <br />s MailingAddress Pro e Address if diff a in <br />Brent from mailing address) <br />8655 271' Street ld <br />City State 't Zip .___. City v 5tatc Zip <br />Lake Elmo i MN 55042 f <br />DESCRIPTION OF PROPERTY <br />Property ID Number <br />MP Number <br />21,029.21.13.0002 <br />Legal 17escrip6on of Property <br />City or Township chool striet # TAG <br />Tabl n Park Lot 8 Block 1 Subdivision Cd 37750 <br />Lake Elmo 622 <br />ASSESSOR'S ESTIMATED MARKET VALUE <br />Original: <br />Land EM1Improvement }SMV Total Classibcation <br />Revised: <br />Land k,MV Improvement i MV Total Classification <br />Applicant's Statement of Facts., <br />pppjicant's Request: <br />Please abate: the 2006 Street Repairs assessment to the amount of $276.85 This was paid by the taxpayer In June 2091. <br />Applicant's Signature;f i Wiz. hate: <br />Note: Minnesota Statute's 1988, Seetion 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 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 payment of a fine of not more than $3,000.00 or both. <br />Note: Must include City/Fownship Resolution for reductions on assessments <br />Note: Must include Fire re ort for Local Option Disaster Credit <br />1 Rev 5/Io <br />