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<br />~ JI. JI. ............... /V'''' \..~~.~... J'~'JVJ <br /> <br />n.....~.............V_ ........y-. ...._..._... ..... ~....... .....__... <br /> <br />. <br /> <br />Applicationfor Approval of a New Use of Tax-Forfeited Lands <br />(MinnesOta Statutes, Sectiou 282.01, Subdivisions la through Ie) <br />In RAMSEY County <br /> <br />.' <br /> <br />Name ofgavemmental subdivision (applicant): L.' J--y ~f- /lr./<Wo <br /> <br />Mailing address of applicant: /,pl'5 f1{..h~/M,", '7'" ,4r../~ <br />... r / <br /> <br />State deed number: 0136291 Date state deed issued: <br /> <br />.1;7,,// f <br /> <br />1'/1 J/ f, frW <br />Avril <br />(month) <br /> <br />q; II -z. <br /> <br />3rd <br />(day) <br /> <br />1970 <br />(year) <br /> <br />Legal description of property (include the name of the city/town in which the property is located): <br /> <br />Lot 5, Block 2, "Lake Josephine Villas" <br /> <br />PIN: 34-30-2344-0040 (A) <br /> <br />Describe the intended public use for which the property was previously conveyed (be specific, including statute or special law <br /> <br />references, if relevant): _ / <br />/Jur.IL ____ "'.......,.., ~~ <br />/ ' <br /> <br />Describe the new public use fur the property that is being requested (be specific, including statute or special law references, if <br />relevant): <br />Dr""/r?~ - /?7/;.v.~7",,1-& -; h..1-~.f~ ';;>''if';? """ / <br /> <br /><<:1S INSTRUMENT WAS DRAFTED BY: <br />-44re-T> ,A/"d$l <br />Name <br />J-r>'17' #/~'7' 7"./J~ <br />.Addi-ess . /' ' <br /> <br />/1/11.1 i?'>^' <br />, <br /> <br />">-:;//2. <br />- <br /> <br />STATE OF MINNESOTA <br /> <br />) <br />) ss. <br />) <br /> <br />County of RAMSEY <br /> <br />being first duly sworn, deposes and says that he/she is the authorized <br />representative of the governmental subdivision (applicant) nained herein, that helshe has read said application and knows the contents <br />thereof, and that the matters stated therein are true and correct. <br /> <br />Name <br /> <br />Title <br /> <br />Subscribed and sworn to before me this <br /> <br />day of <br /> <br />,20 <br /> <br />Notary Public, <br /> <br />County, Minn. <br /> <br />My commission expires <br /> <br />.eturn application to: MN Department of Revenue . Property Tax Division. Mail Station 3340. St. Paul, MN 55146-3340 <br />