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HomeMy WebLinkAboutKoetter Woodworking Inc./~ cOMPLIANCE WITH STATEMENT OF BENEFITS ~'~ StateForm~.973(R2 IlI-g5) ~o~I mu~t file ~is form wit~ t,he Coun~ Aud~r ......... r~ whoS~ Statement of Benefits .~- .~ has b~n comphanCe IName el t~payer ~ , .,~ :Name o~ des~gnzung Occy /~ .... ~ ~O/~'J C L I N~mber Of em2tcyees .e;a~.~=o _ ~ : / . ~ i Salaries ~ ~;~.::~.::......C&st?i~:i~=..:~:....~! Asses L -~ , ~uoo~com~e~n°~;ec~~ ~ ~n~ · · .. ~ Assessed Vatue ..... ~~ ~ . ~o~ '.. - ,, ' - ~ Pt~s: Values o{ oro~sed pro1ect~ I . ~, o c~i~ th=' the r~2-ese~:ation$ i~ this s~~ tr~. O~mC'' d~)~ INSTRUCTIONS: I. FWth/n ferv/.five f4 =~ ~- -- . · . . . & If &~e p~a~ owner is ~und N · ··. g ...... ~uy ar t~e wn~en not/c= property Owner is found not to b,~ in s-~- ....... ' - · ,,,,uwmg aate ~nd time ~s ~e~n s~t ~sj~ ~'ff] a~ compliance, me prope~ owner sh~ll ~ ~ receive the ooponuni~ for a he~dne. 7 Lc~dcn of hea~ng -- H~RING RESULTS (to ~ ~mp~t~ a~er the h~ ~ Approved "" ~~zr/) ~ Denied (see instruct/on ~ove)