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Anoka County Division ofPropaty Records & Taxation Abatement Form 7 (Rev 2J9~) APPLICATION FOR ABATEMENT - SPECIAL ASSESSMENTS (M,S.375.192) County Auditor's Number For Taxes Assessed in 2 And Payable in 20 County of Anoka Applicant's Name: City ofCenterville Applicant's Mailiog Address: 1880 Main Street Applicant's Social Security Number: Centerville, MN 55038-9497 Applicant's Telephone Number: 651429-3232 Date of Application: January 29, 2008 DESCRIPTION OF PROPERTY Lot 2, Property J.D. or Parcel Nwnber: RI4-31-22-31- Block 2, Peltier Preserve 0043 Street Address (if different than above) 7320 City or Township: Scbool District Number: Peltier Circle Centerville 12 007 08 LEGAL DESCRIPTION OF PROPERTY: Lot 2, Block 2 Peltier Preserve APPLICANT'S REQUEST: Include fund number & amount due for payable tax year being abated, not total principal amount. FUND #84209 $753.78 - 2008 Applicant's Signature Date NOTE: Minnesota StatIJt~s 1988, Section 609.41, "Whoever, in making any statement, oral Qr written, whicb is required or authorized by law to be made os a basis of imposing. .reducing or abating any tax or assessment, intentionally makes any statement as to any matcri.al matter which the maker oftbe Statement knows is fulse my be sentenced. unless otherwise provided by law, to i..mp"isonmad fur not more th.an one year or to payment ofa fine of not more than $3,000 or both:' The following accurately reflects both existing and proposed amounts Tax Special Waste Penalty Interest Costs Total Assessments Fee Orilrinal Proposed . Reduction Tax is Paid Date: ,20_ o Equal Annual o Declining Balaoce o Flat Tax o Abatem o Increase o o Tax is NOT Paid REPORT OF INVESTIGATION -16-