Res. #10-006 - Special Assessment Abatement

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APPLICATION FOR ABATEMENT /ADDITION OF - SPECIAL ASSESSMENTS For Taxes Assessed in 2009 and Payable in 2010 Please print or type. Applicant/ Owner Jeffre Nomura Applicant/ Owner Mailing Address 1880 Main Street for 7238 Main Street Applicant/ Owner Telephone Number 651 - 47Q - 3732 Centerville, MN 55038 Date of Application 02 -23 -10 DESCRIPTION OF PROPERTY Property LD. or Parcel Number R#14 -31 -22.33 -0001 Street Address (if different than above) City or Township School District Number 12 LEGAL DESCRIPTION OF PROPERTY APPLICANT'S STATEMENT OF FACTS Resident was allowed to make payment in full for Principal Remaining subsequent to November 15, 2009. Ck #2703, Receipt #6091 - $1,662.97 APPLICANT'S REQUEST Include fund number & amount due for payable tax year being abated, not total principal amount. Fund #83576 2010 - $645.30 2011 - $645.30 2012 - $645.30 _ _ � _ • Applicant's Signature s ate NOTE: Minnesota Statutes 1988, Section 609A1, " 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 of a fine of not more than S3,000, or both."