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' Metropolitan Council � Environmental Services MCES Affidavit-D I 390 Robert Street North Last Updated: 12/11/2013 ' St. Paul, Minnesota 55101-1805 651.602.1421 �651.602.1030 fax Sewer Availabiliry Charge(SAC) 2014 AFFIDAVIT OF PROPERTY USE This Affidavit of Property Use is to verify the demand on this property for SAC purposes for Non-Conforming Credit when there is no evidence of SAC paid for the existing demand and no documentation can be found for the two types of Non-Conforming Credit: 1) Grandparent Demand (demand used prior to 1973 when the SAC program began with evidence between 1968-1978); and 2) Long Continuous Demand (demand for 10 years or more up through 3 years prior to current SAC Determination or permit issuance . Property Address: 3 � �H�,��r�� Q� Customer Community: �2�va Parcel Identification Number: ��-11-� -Z3 - `i�l - o�c�t� Dates of Non-Conforming Credit: Z- Z-� - � � q 5 through �- � �- � i I Type of Non-Conforming Credit: Grandparent Demand � Long Continuous Demand I certify that Customer Community staff has researched the above property and have found none of the items listed below for activity at this address: - Dated Building Plan(s) associated with a building permit - Building Inspection record(s) stating the actual use of the property - Business License(s) - Building or County Assessment Record(s) Although no written proof exists, I believe the demand of this property includes (must be specific in what was there and, if more than one demand include the amount of square feet for each specific use): ��7 �P�Ck: (,,J�AS (/�j R G,� �S �4 /—��/Z_ S'/k L4/�l .� �JL �N�l I�7�`'+.12 �/�5I-{I�ON� _�:/�„�1>1^ �3 /�'/�l� •`�.-n '� �c__., Zo)! Lv H-c '"� 1� !.v�� C'l-!,�rv��.� <-� .r ;i� �i c /��5 g uS�n�-P5� �. and was used in this manner during the Non-Conforming Credit dates as stated above. I hereby certify that I have read and understood this affidavit and that the statements are true to my knowledge and belief. I further understand that the giving of false information in this affidavit constitutes fraud and is also cause for the immediate redetermination of any charges. I have no conflict of interest in this matter. Print Name of Community Official: L�LC QM 1�/°� Community Building/SAC Official Signature of Community Official: �`,1Jw�t,�; Date: � Z - 2,.2 � �-01�-J i: Print Name of Community Official: Department Head of Building or SAC Official Signature of Community Official: Date: