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~,~ ti~ ulv 1 ~ <br />(:tav. X901 ~i ~:+ <br />r -~ 4 <br />- AFF4iCATiON i=C? PRCPER`~' TAi. E:C r'rIPTION <br />~J <br />~a:[n;y J 1+\~J G ~ Town o; City <br />Qti+ner I 1 /<< 1 ~~~ ;Ll 7.P~ 1J ~% ~ ~ N (~' ~. _ ~~~ ~ t~t/l(7 ~t t ~`~ ~-G~1 ~ V"G~~ ._._ <br />Ada:.,=~(~Wy~1 L}~~:`~~~n.t Z°P~:~~ C~~^cG. ~~ ~!i!i.~6%r~a~~-~~ _.. ~~C~ -,2?~e <br />(S:rat; +r ioute7 (TortO (Sts:a~ (.',ip Gode) <br />1. `~ G `7 .l ~ ',~ti, ~ ~ . <br />La caltpn of Arp.rt; <br />lr: ~cic: ro rrs <br />Under tha prv.i sivaa er C. 5. [oi-«E Zl araty v+n er of property elaimin; csergplivp er aselu aion from property taxaa twat <br />davaaatpt= (flat Lhe propetcy plKt: tSa }4tutpr7 ragnlftbeara tar aiemplivn or elaaflfe}tiaa. f~aima tar Cxempl(on pr aiclu+ <br />aipn molt Le tilyd rith the tax auperrisu et the count} ix which Lhe property is located. (aae rc~arsa side? Glaina tot cxemo-. <br />tips shoe ld iaeludn all lxr.d rod ic}pro.a~cam and perineel preparty }ituatcd :hereon and complete in(ormaeion ra iardio; iu uae. <br />Thcundcrsig:tcdownc: yr autErorixcd rcp:esantxtivc hereby petitjvrs Car exemption o[ the Collawjng described prop- <br />erty: p ~r y~ <br />2. Give complete deserptiort a[ prcpctty: `I~`~ UNr"u''^` t'~i~`''1 ~`"~' `~~e+~. ~~j(J~[j~~ <br />Land: r U 7 <br />[cop vemctts• ~. 1'- + e'S ~~ .: ~r~li2. ~'~~ <br />i ,... g'~ <br />Personal Ptvpetty: <br />~. List and~salaip t}!c purposes Cvr which the properly is used:, „ _ <br />Personal Prvpcr;y:: <br />~. I[ any OCy~gl2atip' pLtlCt :han the owner uses the property, give the name of the vrganixativn, Cull particulars <br />regarding jis ssa c[ the properjy and the amour t of any income rcc:ived Cor such usa. <br />` ~~ <br />) <br />;- ~~~ <br />~~,~Sh <br />5. Give your =s:irrata of the t sr a value 6. List th, irsutancc va;ua o[ the prepcrty: <br />in mane•r o:' the prrpc;e~: <br />Land ~' ~ zzzzzzzzxaxxx:.z- .x:zzxzzxxzxxzzzxzsx ~ <br />lm?raecmc~ts `~-~ .7~~~_ ~~ 9G°rJ YET. , ~ i ~ ~;~ '•s~. :) <br />Persona! Property: ~~r-=`L _~ ._~r~~~~j <br />(i. Upon what uses or pu.~vses da you base this claim Cor eze:aptivn? Charitable ( ): Religious (~ <br />Edut~tjor.al ( ); Literary ( ); Scicntif;c ( ); Other <br />71 •• <br />7. Give the speci[ie statutory authorj:y upon which thjs propc:rys claimed ss cze:rtpt: ~~ ~ _1 ~ 0 ~ ~,~~J <br />[roil texts of al! rx~-rprian Grid el:ssiricatior. s:a:u:es are availeplt at the a;jtce o f the county tar supen!iso:.l <br />Under pesrsl[ic} prra e: jh ad "pry la., j hcreL7 x:rrm that m the Srat ai etf• ;,eo•.led;o and Selicf, Ma terateeneg4 and jafv~aiion is :his <br />spplintiaa arc :sue opd r~rrcet, and :re made 'pr ~e purewxe of vsemptini the property herein de}/eriLed trva •+=atioa. <br />r~acYrt: of orncr or :rthart2cd rcprcd en to ore <br />.r <br />f 1 ~ r~~y ~~ <br />Title Telcvnonc tiv. <br />~. ~ -~ .+ <br />~~ ~ .~ ~~~~ I~ r <br />lmprvvcrtcn~s: _.~~~ '~J----'~: Lv-• - ~ -• - ~ - - - ~-. <br />r <br />