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Hennepin County Government Center <br />Department of Property Tax and Public Records <br />A-607 -Attn: ID Controller <br />Minneapolis, MN 55487 <br />I hereby make request for a combined assessment and legal combination of the following described <br />land: <br />and <br />Orig. PID # <br />Orig. Address: <br />Legal description: <br />Orig. PID # <br />Orig. Address: <br />Legal description: <br />New Address: <br />Municipal Code: 38 <br />Printed name: <br />Title: <br />Fee Owner and Taxpayer <br />Date: <br />Taxpayer's Address: <br />PO Box 188 <br />Excelsior MN 55331 <br />22-117-23-42-0020 <br />530 Big Island <br />Part of Rearrangement of Lot 1 of Kitchel's Subdivision <br />Government Lots 5 and 6 in Sec 22 T.117 R. 23 <br />22-117-23-42-0019 <br />520 Big Island <br />Part of Rearrangement of Lot 1 ofKitchel's Subdivision of <br />Government Lots 5 and 6 in Sec 22 T. 11 7 R. 23 <br />520 Big Island <br />Tax Year: 2010 <br />D I -Pending Combinations (Deputy Clerk) D I -Street File