HomeMy WebLinkAboutCC 12.6.16_SA Abatement form WASHINGTON COUNTY ASSESSMENT DIVISION
APPLICATION FOR ABATEMENT-GENERAL FORM
CLASSIFICATION/DISASTER CREDIT/SPECIAL ASSESSMENTS
Received: Assessment Year: 2015
orksheet# Payable Year: 2016
APPLICANT
Owner's Name (please print or type) Soc.Sec./Fed ID ph,me Cell
Pete Schiltgen
Owner's Name Sec.Sec./Fed ID Phone Cell
Owner's Name Soc.Sec./Fed ID Phone Cell
Owner's Mailing Address Property Address(if different m mailing address)
10880 Stillwater Boulevard
City State Zip City State Zip
Lake Elmo MN 55042
DESCRIPTION OF PROPERTY
Property ID Number Linked Group Number
13.029.21.24.0001
Legal Description of Property City or Township School District# TAG
Lake Elmo 834
ASSESSOR'S ESTIMATED MARKET VALUE
Original:
Land EMV hnprovemcnt EMV Total Class
0
Revised:
Land EMV hnprovement EMV Total Class
0
Applicant's Statement of Facts:
The City of Lake Elmo processed this as a regular as a regular assessment rather than deferred(parcel in Green Acres).
:kpplicant's Request:
Abate the special assessment and interest for Pay 2016(outstanding balance)in the amount of$11,727.73.
($6,933.33 princ and$4,794.40 int)
Applicant's Signature: Date: 2
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 5/12