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<br />. - <br /> APPLICATION FOR DEFERMENT OF SPECIAL ASSESSMENTS <br />. To the city council of the City of Arden Hills, 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 /> 7l/~ XA'Av_-, 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 I s adjusted gross income is $,J::z. 9.57.~:4.. <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 ~ity the deferred as sment with interest. <br /> ~cVvV <br /> _Dated t /7' c:<, <br /> nt <br /> Subscribed andS%Orn to 8 RENEE M. KAULFUSS <br /> before e this o'f/'^--' day ,.~:)T ARY PUBLIC.MINNESOTA <br /> of , -B&9 /7'7' 2r HENNEPIN COUNTY <br /> ~.:y Commission Expires ~-97 <br /> /J!~ - <br /> r <br /> --. <br />. <br />