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�� ����6��Ac�waf [�'�f��l 7�Twnc.Sul� p�yiarJu:,�ut uf Rul���� <br />` Fi�aPda .kIG {'.oFro-apoii�� <br />Application by a Governmental Subdivision for Conveyance of <br />Tax-Forfeited Lands for an Authorized Public Use <br />(Minnesota Statutes, Section 282.01, Subdivisions 1 a through 1e} <br />(Note: If the governmental subdivision has purchased the property, use PT Form 80) <br />In �t,A,NlS�X County <br />Name o f governmental subdivision (applicant): CITY OF ROS�VXL�.,� <br />Mailing address o f applicant.• 2660 CIVIC CENTER ��VE <br />ROSEVILLE, MN 55113-1899 <br />Date requestedproperty was forfeited to the Stale: �u,�ust I 2006 . <br />(month) t�?� � ����� <br />Legal description ofproperty (include the name o f the city/town in which the pYOpeYty is located): <br />� Tract D, RegisteredLand SurveyNo. 530 <br />�z�t: ii-29-23-ii-oo3� �T�, <br />CONTRACT.• <br />Describe the intended public use to be made of the properry (be specific, including statute or special law <br />references, if relevant): <br />State the need for tla� properry (be s�eci�c, e.g., why this properry insteadof some other properly?): <br />Please check the appropriate boxes below: <br />❑ correcting governmental subd. nax�e ❑"�nere are one or more wells on this properry <br />and/vr <br />[� legal description �"I'hexe are no v�rel]s on this properry <br />original deed no. <br />(If recorded, please supply recardin� information. <br />If not recorded, please return the original state deed.) <br />A Wetland Certification Form Must Be Attached To This Application <br />Return application to: MN IIepartment of Revenue' Property TaM pivis'ran' Mail Station 3340 S t. Paul, MN 551�EG-3394 <br />