Request for Drain Assessment Payoff 2015.xlsx

Allegan County ‐ Office of the Drain Commissioner
113 Chestnut Street
Allegan, MI 49010
(269) 673‐0440
(269) 673‐0396 Fax
Date: ______________________
Attention: Payoff requests WILL NOT BE GIVEN OVER THE PHONE . All requests must be in writing.
DRAIN ASSESSMENT PAYOFF REQUEST
Company Name:
Address:
City, State, ZIP Code
Contact Name
Contact Phone #
E‐mail address
Fax #
PARCEL NUMBER
PROPERTY ADDRESS
REQUESTED PAYOFF DATE
(if known) DRAIN NAME
(if known) DRAIN NUMBER
(Drain Office Use Only)
PAYOFF AMOUNT DUE:
Years Paid:
THRU:
Years Remaining
Total Years:
PARCEL NUMBER
PROPERTY ADDRESS
REQUESTED PAYOFF DATE
(if known) DRAIN NAME
(if known) DRAIN NUMBER
(Drain Office Use Only)
PAYOFF AMOUNT DUE:
Years Paid:
THRU:
Years Remaining
Total Years:
PARCEL NUMBER
PROPERTY ADDRESS
REQUESTED PAYOFF DATE
(if known) DRAIN NAME
(if known) DRAIN NUMBER
(Drain Office Use Only)
PAYOFF AMOUNT DUE:
Years Paid:
THRU:
Years Remaining
Total Years:
ATTENTION: Payoff requests WILL NOT BE GIVEN OVER THE PHONE. Methods to submit form: [email protected] OR Fax (269) 673‐0396
Requests must be received 48 hours in advance and will be answered on Monday ‐ Wednesday ‐ Friday
The Annual Assessment Summary report is available on the County's website on the Drain Office webpage. The report will display all drains assessed in that specific year and if the drain is a multi‐year assessment. (www.allegancounty.org)