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<br /> . . <br /> . APPLICATION FOR DEFERMENT OF SPECIAL ASSESSMENTS <br /> To the City Council of the city of Arden Hills, <br /> Ramsey county, <br /> Minnesota. (Applicant) being <br /> first duly sworn deposes and states: <br /> 1. That the Applicant is the owner the following described <br /> real estate located in he city Arden Hills, Ramsey <br /> County, nnesota: <br /> ~ <br /> . <br /> 2 . Pursuant to Minn. stat. S435.192, et. seq. and the Arden <br /> Hill assessment manual, Applicant requests deferral of the <br /> payment of special assessment for the <br /> /( ., ~ .5("c~ improvement. <br /> 3 . In support of this request, Applicant represents as follows: <br /> e Applicant is over 65 years of age; <br /> b. Applicant is permanently and totally disabled as <br /> follows: <br /> . <br /> . c. Applicant's adjusted gross income is SA. 9.5l. ...1:J.. <br /> 4. Applicant declares that the foregoing information is true <br /> and correct and agrees to immediately inform the Arden Hills <br /> Clerk Administrator should any of the foregoing information <br /> change, and agrees that if the deferral is granted, <br /> Applicant will immediately upon termination of the deferral <br /> pay to ~~i~ the deferred as sment with interest. <br /> aJvV <br /> _Dated b / '/ ,;z <br /> Subscribed ands60rn to 0 RENEE M. KAUlFUSS <br /> before me this :o~ day ,,'::IT ARY PUBlIC.MINNESOTA <br /> of , -30-9&9 /ff/;r II"NNEPIN COUNTY <br /> ~.:y Commission Expires a-;..97 <br /> /Jf~ .~- <br /> , <br /> -- -, <br /> . <br /> _.~...- <br />