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<br />. SENT BY: <br /> <br />5- 4-58; 15:17; <br /> <br />PROP REC & TAX- <br /> <br />612 425 8629;# 2/ 2 <br /> <br />( .. <br />n } 1.,. ( <br />V~'bl! - <br /> <br />OpVision <br />\.. ,rl <br />,JiQ Combination <br /> <br />DIVISION / ~OMBINATION REQUEST FORM <br />Municipality &i~,ifA'\;ln~ Date <br />For taxes payable in ~ Z-f)O-Z <br /> <br />',ID r! Ii' ')),1>" <br />~.f:.. ,.\.,"",/1,/..... ~ <br />, <br /> <br />Fee Owner: <br /> <br />Contract <br />Purchaser: <br /> <br />Taxpayer Name: 77rlb;<<.A 5' --p ;/vi/')(;..,1)t..iSC: J< <br />Address: /;JY? C (.1 rJ e }"<-!)'-t LA: ;!d <br />Cf",Trrv,I-lJ) ,I,/M,--J s-~oH <br /> <br />Pin <br /> <br />Key# <br /> <br />Legal Description <br /> <br />Kd3 I ~ 33 Mo" <br />1G3 31 dJ'~ 66f./O /Ij'~ /6661 <br /> <br />NJ.i)g.7 ,,;'fJJf Co3T IAc.JU3 <br /> <br />StI,,'7A) u.s" of tV' ~ ",iT,"" $j.lS y''/ <br />or ,,$<>!jo/tI," 5i't.~.a -) g.:) <br /> <br />o I <br /> <br />Note: If this is a request for a division of a tax parcel, the legal descriptions of the new <br />parcels must be attached and stamped with olty approval. As 01 June 1, 1993 <br />there will be a f88 for dividing property. <br /> <br />CirJ) <br /> <br />Daytime Phone# c;;) >-"-- dl LJ 6 <br /> <br />C/ ~~./"'----- <br />OFee Owner -.. <br /> <br />OContraot Purchaser <br /> <br />Note: If the request is by a contract purchaser, the applicant must already appear as the <br />contract purchaser in the county tax records or a copy of the contract for deed must be <br />attached. <br /> <br />OFFICE USE ONLY: <br /> <br />Checked lor delinquent taxes by: <br /> <br />Date: <br />