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I'\nOKlI '~oilnty lJlVISIOn 01 rropert)' Kecoras "" laxanon I'\oatement rorm ',Kev ""'} f, APPLICATION FOR ABATEMENT - SPECIAL ASSESSMENTS (M.S. 375.192) For Taxes Assessed in 19 qq and Payable in 1999-2008-:~' Please print or type. Applicant's Name Ci ty of Center Applicant's Mailing Address Applicant's Social Security Number Applicant'sTelephoneNumber (651) 429-3232 City of Centerville 1880 Main Street Centerville, MN 55038 Date of Application 10/6/00 DESCRIPTION OF PROPERTY Property 1.0. or Parcel Number R23-31-22- City or Township Street Address (if different than above) 6973 Meadow Circle LEGAL DESCRIPTION OF PROPERTY LOT/UNIT 16 BLK/TRACT 2 PARKVIEW APPLICANT'S STATEMENT OF FACTS O~ July 9, i999 the City of Centerville received payment in full from Tltle (Ck #91831) to satisfy the special assessments on Lot 16 Block ~IJ .23-31-22-31-0064. The City of Centerville inaccurately ~pdated lnt__nal records and did not notify the County of payment in full. Burnett 2 their APPLICANT'S REQUEST Include fund number & amount due for payable tax year being abated, not total principal amount Fund 82840 2000 - $1,846.47 2001 - $1,846.47 2002 - $1,846.47 2003 - $1,846.47 2004 - $1,846.47 2004 2005 2006 2007 2008 $1,846.47 $1,846.47 $1,846.47 $1,846.47 $1,846.47 Applicant's Signature Date NOTE: Minnesota Statutes 1988, Section 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 which the matter of the statement knows is false my be sentenced, unless otherwise provided by law, to imprisonment for not more than one year or to payment ofa fine of not more than $3.000. or both."