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HomeMy WebLinkAboutCC 5 17 16 abatement form_consent #8 WAS INGTON COUNTY ASSESSMENT DIVISION APPLICATION FOR ABATEMENT® GENERAL FORM CLASSIFICATION I DISASTER CREDIT/SPECIAL ASSESSMENTS Received: Assessment Year: 2015 orksheet# Payable Year: 2016 APPLICANT Owner's Name (please print or type) soc Sec Fed ID Phone Cell Jerome Junker Owners Name Soc.Sec rt-7 ID Phor e, Cerl Owner's Name Sec.See./Fed 1D Phone Celi Owner`s Mailing Address Prop zty Address(tfdif,',turn n?ailing address) Ill 30 20th Street Ct City State �5504�2 L s`t} State Lip Lake Elmo 1N DESCRIPTION OF PROPERTY Property ID Number Linked Group Number 24.029.21.33.0010 Legal Dese6ption of Property City or township School Disnict# TAG Lake Elmo 834 ASSESSOR'S ESTIMATED MARKET VALUE Original: l rnd EMV bnprovement EMV Total Class Revised: Land EMV hnprovement EMV Total Class Applicant's Statement of facts: The City of Lake Elmo_assessed this parcel for the 2014 street project assessment in error. Proceeds were received by the City of Lake Elmo on 10.29.15 Applicant's Request: Abate the special assessment and interest for Pay 2016 in the amount of$730.50. ($500 prin$230.50 int) f k. £ y � r Applicant's Signature: �.., rl t I;, a .,. ,� ..... Date: t` NOTE: M.S. §609.41,"Whoever,in making any statement,oral or written,which is required or authorized by law to be made as a basis of imposing,reducing,or abating any tax or assessment,intentionally makes any statement(as to any material matter whi Note: Must include city/Township Resolution for reductions on assessments Note: Must include Fire report for Local Option Disaster Credit 1 Rev 5/3 2 OFFICE USE ONLY Taxes ORIGINAL Class EMIVL EMVI EMIV TMIV Tax Capacity Credits SPASS Total Tax _ LNTC _Val Grp-1 TIF' — Val Grp-2 - FD Val Gip-3 STATE Val Grp-4 -- - RMV Val Grp-5 PWRL CR - --- TOTAL AG CR HST CR 1' TOTAL' Taxes REVISED Class EMIVL EMVI EMIV TMIV Tax Capacity Credits SPASS Total Tax LNTC -Val Grp- l --�— �---� — ----� TIF— Val Grp-2 Val Grp3 �-�- -- ---� - ------- - _ STATE Val Gip — -- --�- - RMV Val Grp-5 - ( PWRL CR TOTAL I - - - AGCRI HST CR i TOTAL I - TOTAL DIFFERENCE PORT OF INVESTIGATION ❑ Tax is paid as of: Local Tax Rate: ❑ Tax NOT paid as of: RMV Rate: After examining the applicant's claims,I have carefully investigated this application and find the facts to be as follows: Investigator's Signature: Date: -� -- CERTIFICATE OF APPROVAL-COUNTY ASSESSOR Note:(under$10,000)Fbr this abatement to be approved, the Assessor and Director of Property Records&Taxpayer Services must both favorable recommend its adoption. ASSESSOR'S RECOMMENDATION(County Assessor or City Assessor) CRITERIA: Apved Ded Assessor's Signature �— Date: (DIRECTOR'S RECOMMENDATION Apn ved —D�ed -- -- — Director's Signature---- - --- --- Date: COUNTY BOARD OF COMMISSIONER'S- COUNTY AUDITOR Note:For abatements resulting in a change of$10,000 and above including tax,penalty and interest. For this abatement to be approved,the Assessor,Director of Property Records&Taxpayer Services,and the County Board of Commissioners must all favorab ApOved —Denied-1 Auditor's Signature Date: I certify that at a meeting held(month,day)__ (year) —the County Board of Commissioners took the above action on this abatement. This action was duly adopted and entered upon the minutes of its proceedings as a public record,s 2 Rev 5/12