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APPLICATION FOR REVIEW OF REAL ESTATE ASSESSMENT
Address of Property it)
• Owner on January 1, 197 4 5v RR 7 :7 T F,12)/ CO.
Year Land was Purchased Amount Paid
Year Land and Bldgs. Purchased ( 9 3-7 Amount Paid .
Approximate Age of House Original Cost, if Known
Apploximate Age of Other Bldgs. e 4Z4..S Original Cost, if Known
Give the approximate cost of any other improvements or alterations not included above:
Year Installed Cost
:s. of Improvements
Do the costs given above include the value of all labor and materials necessary to complete the construction? If not, please explain
Were the buildings constructed by a contractor or by the owner? Nr( °1414.a,- ,9(' Aikevi 0/110t4till.
The total Fire Insurance coverage on the buildings is
1 rentals received per Month .B.U.ileb/JV et- IS U5r) By ev0A4-P Ey( L I
ca zgage on the property is
re to sell the property at the present time, what would you expect the Sale Price to be?
hily other factors that you wish to be considered. 7-01Inj ,` -7-ke 'la I 8 en a itestietict
aAA4 sAitc.4 (&. u.s.e , 73cloce
*e- tituha rep)6re a It-amakirr uokiLl,k I S kAt- ab
Signed C. -
to *)er Date 7Pecem 444 ?7
/170. 73LJ
feels- 701,1; chat...A-0 C F ) 710 AA 4&.
O'Nekir — 1(?(-0 . 0/0110c - e-es-s.
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RECOM-
INTV NO. MENDATIONS NC CM REV INSP INS BY REV. BY NC CM