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APPLICATION FOR ABATEMENT/ADDITION OF - SPECIAL ASSESSMENTS <br />For Taxes Assessed in 2 009 <br />and Payable in 20 <br />Please print or type. <br />Applicant/ Owne low Fehrenharh I Applicant/ Owner Mailing Address <br />1880 Main Street for 7340 Peltier Circle <br />Applicant/ Owner Telephone Numb 6 -zoz) i Centerville, MN 55038 <br />Date of Application 02 -23 -10 <br />DESCRIPTION OF PROPERTY I Property I.I. or Parcel Number R#14- 31 -22 -31 -0045 <br />Street Address (if different than above) City or Township School District Number <br />12 <br />LEGAL DESCRIPTION OF PROPERTY <br />Lot 4, Block 1, Peltier Preserve <br />APPLICANT'S STATEMENT OF FACTS <br />Due to original shortage of payment in 2009, assessment was left on roll. Payment was received in full Febnmy 23, 2010. <br />APPLICANT'S REQUEST <br />Include fund number & amount due for payable tax year being abated, not total principal amount. <br />Fund #83762 — 2010 - $3,557.56 <br />2011- $3,557.56 <br />2012 - $3,557.56 <br />2013 - $3,557.56 <br />Applicant's Signature Date <br />NOTE: Minnesota Statutes 1988, Section 609.41, "Whoever, in making any statement, oral or written, which is required or authorized bylaw to be mad <br />a basis of imposing, reducing or abating any tax or assessment, intentionally makes any statement as to any material matter which the matter of t <br />statement knows is false my be sentenced, unless otherwise provided by law, to imprisonment for not more than one year or to payment of a fine o. <br />not more than $3,000, or both." <br />14 <br />