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HENNEPIN COUNTY PARCEL DIVISION OR COMBINATION OWNER REQUEST FORM <br /> Parcel Identification and Platting Supervisor <br /> Resident and Real Estate Services <br /> A-500 Government Center <br /> Minneapolis,MN 55487-0060 <br /> Email: RRES.PropertylDandPlatsQHennepin.us <br /> Telephone: 612-348-3271 <br /> DATE: Z'I3/1-0 20 <br /> I hereby make a request for a(separate/combined) assessment on the following described land: <br /> I.D.No. 0(6r1Z33L100 ('Z.. I.D.No. <br /> I.D.No. Oat i ZZ33G 00 l I I.D.No. <br /> I.D.No. I.D.No. <br /> (For additional I.D.No's add an attachment) <br /> Remarks: <br /> City of Ca-01-30 <br /> For 715'10 Tax Year fi / i <br /> Signature of Fee Owner <br /> Address 710 V z.e vel �piezAccu .( <br /> Telephone# (9 t2— 1C° - SO <br /> Mail Tax Statements to: <br /> (t Awe-SS Neo.Jc <br /> 11Page <br />