HomeMy WebLinkAboutBLD1992-00251 •
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OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE NOPlE QUESTIONNAIRE
RP Account 0
PP Account II
DATE 4-///- 0 3 - gv2
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Please rend the entire form and provide as much information as possible. This will
help us identify the unit correctly and avoid double assessments. It will also aid
in placing a correct value on your property.
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REASON FOR INQUIRY:
Field visit Excise tax Building Moving
by deputy affidavit
permit • permit
Dealer report Application
Delinquent State transfer by sale for title taxes
report
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• NOB ME NONE ,owwttt RS►IIP/occut'AN'r DATA ;
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Name(s) /`�/¢/ G$� LIA/
Street or Bor. Q• Av)i 163 7
City P061 /.5 0 State/Zip Abi, 9 p3 7 0
Home phone 22 -`� di Work phone'
Nest time to call ,&`2C7-0,PGr 3 A m
(specify home or work)
NOTE: If you rent the mobile home give name, address, and telephone number of
owner here
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MOBILE NOME DATA:
Length /
W , a
(exclude hitch) Width Model Year , � 9,9--
Make 6e). C/j /i1 es -7" Model /Y,-.0dhG,r
Serial number ig 0 -/0 ?b9 /
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MOBILE HOME LOCATION - IN PARK
Park name ®/Ut t-62 tie-e / 'c Ac
Space n 3 - -f— Date placed in park 7-;) t /41 C e G�
(PLEASE COMPLETE REVERSE SIDE)