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City of Orono Special Assessment Waiver <br /> Property Address: 1955 Heritage Drive <br /> Project: Sanitary Sewer Extension <br /> Assessment Amount: $14,400 <br /> Assessment Term: 15 Years <br /> Annual Interest Rate: 6.25% <br /> Assessment First Year: 2004 <br /> I hereby request to have a special assessment levied against my property per the terms specified <br /> above and waive any rights to the public hearing process and other procedural requirements in <br /> the assessment approval process and also the assessment appeal rights applicable to special <br /> assessments under Minnesota State Statues. <br /> CC%'�Ci� �— <br /> Property Owner Signature Property Owner Signature <br /> ��� �� <br /> Print Name Print Name <br />