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� zo� 2 <br /> T�a a�F���p W,T� Ex�rr�ption �4ppl�c�ti�r� �u�� <br /> YQUR �a�.-����x����ian on Reaf and Persanal Property hy t�uaEifying Drgartizatian� "� <br /> COUhIY ASSESSQR Read instructians on reverse side. �� t <br /> ' Faikure to properly complsfe ar fi{e this appiication in a timeBy manner shali resuit in a disappraval v9 the exempiian. � <br /> Name of�Jrgar,ization County CGUn;�fVo. �ype vf rJ�rrrership <br /> CALVARY LUTHERAN CHURCH Hall 4� � P�onprotit Gorworatior <br /> atreet or CJ[hi=r h9ai�i>�s�ArJdrrss 5tatr`Niiere Ir,torpqr;�'ec? � Other{upe�ify,i <br /> 1304 N�Ll� NEBRASKA <br /> Gity Stato i ip Gnde Ac[ual Val�e Percel or Locatior,ID NurnL-vr <br /> GRAND ISLAND NE 68803 555,507 <br /> Le3al desyripticn o`re�l praperty and gene;a�deacripYion a�all tdngiklle parsonzl p!opUtty,except licensed motor veh:ces: <br /> CALVARY SUB LOT 5(CHURCH)#400029014 <br /> CONTIN�NTAL GARD�NS LOT '12 BLK 7 UNIT 2 (#12 ST JAMES PL)# 400p38781 <br /> Tifle af Qtficers, .W� <br /> Name I3ireeiors.or Portners Address,Gity,5tate,Zi�Code <br /> -•• - •�••.•--�- .••-----------------•_--•�••••--------------------------------------- -----•-••••.•••�..------------------------------�--••••-••••---------------------------------- <br /> S�r F�i'P� '7C� 11� t _ �, T �l.t' � � ,t�l�'� <br /> �� - � , {i. �' � �t n � � r L: G <br /> --,�.�.i,.���'�4. � ---Fg��� �,��,� _ � .n1��1 a�c;�-.� � �. (r�..���'3 <br /> Pri��ierty desciii�ed�hrrve is i;tiad in the follnwirip exerript category(riie�tse rnark the applicabl=bexes): �� �W~ <br /> �Agr.cultut�:iHcr.iceHural Sac��ty" � Educa?ional �Reli�iou� �Gharit3ble �Cemetery <br /> Gi��a a defai�d descr:ption af thR use of th�prepe�ty: • � _ <br /> �a�sfia�;; r�sfde,�c..e_� ��s.}�,�,Q r�l�� ti s�c�s�:+�s.r aF ��f v�ry <br /> �`�'1�.��iN �I�[.rc�� � L L`'� C��� 3��.-Sy�l(a [�rcA Phan�� <br /> ',�griculturalMnrticultural Society does not naed to compiete the f�llpwing r�uastions. <br /> 13 ell ot,he property usad exdueively�a dascribed abova? . �YEu �NO <br /> ls��iortior.uf the prc�3e�t��used for 1Fi�sa;�ni elc:ohniic beve.rages? �Y�S �NO li Yas,siH;e the�rurnber n?hnur�per week <br /> is the praperty own�d or used by an organi�ation which discriinirates in <br /> merrbership or empL�yment besed vn race,ccl�r,c�r nat!cna!ori�in7 �Y�S �NO <br /> Undcr penalties of 13av,1 dedare that I have examined thi,ezempii�n appiication and,to the besf of my knaw:adg�ard�eliei,it ia conect and <br /> comF�ieTe.I aiso declHte inet i arn duly aotF;crized ta si_r,n ihis exernr�tinn ap�l:catinn. <br /> r <br /> s�g� �� .�'if-�-c�.�- ��� _ t��c S�r - - -------- -'� 2 z �za I�. <br /> h��� ku:horizad Signature — T:tle ��t� <br /> �•-----------------•--•---•-- _•••••.-----------_•••-••-•--� • ••-�-------------------------•-.•••••-.•••�-•----•--------•-------------------------------------------------•-°•-•-•-•-.•-•••-•••.....----------I <br /> ..... ON <br /> FOR CC}l1NTY ASSESSDR'S REGQMh1EPJilATI N W� <br /> �� APPHOV.�\L GO�J�v1ENT5' ��lI U s(tif�JC'1 N �__1_--`,� <br /> � __ .____ <br /> �; A?PR�JVAL DF A P!]R71JN .._._ <br /> ❑ <br /> DISAPFROVAI. - � �`'�^�` �'�-`�:--5� <br /> Sianature o; cu 2y Assassor date <br /> --°•_-•-• �_-•••�-.-• �--••••..•-------°•••._-----_•--�••_•.._--------•••• -•• -��---°-••••-•••••�_....�.._..�..._------• � <br /> �'pR COUNT`!9iDARD F Q41PALfZqTIOPd LlSE QNLY <br /> !derfare ti�at,t�i t�ie hest uf my Rnnw;ed�e and Uelief,the detr.rm:naticr Fisreby r,ade b�,he County F,oard of Fyuafiz%�'iinn is�errect puruant <br /> to[h�lav;s of the�t:�te�f Nebraska. <br /> �A�I�FI�VEI7 COM�IEN1 S: <br /> 7-, <br /> --.. <br /> L; A?PFi(]VP.L OF A PbRTIc�N <br /> C I715AI'PHGV�L7 /��'�°2" <br /> , gnsture of ,ur;ty Bna 1�,9 �er Ua!e <br /> Veyreska Gspur:mant ut aevenue riz .ev ' '%7-202,�? <br /> aG•�73�•7999 Heb'.')-20'10 Supersedes 96-135-1999 NeK 11•-'_��5 <br /> PLEASE MAK�A GQPY FOR YOIJR R�CORqS NOV 2 8 Z011 <br /> HALL GU(�tV fY <br /> GRANDISLAND,��8 pg� <br />