Emergency Management Physical Address Replacement Application UID # 4153
App. Status: Completed
Mike Keyport
218-387-3059
mike.keyport@co.cook.mn.us
 

Terms

Terms and Conditions
  • I hereby certify with my signature that all data on my application forms, plans, are true and correct to the best of my knowledge

Invoice #3712 (08/10/2020)

Charge Cost Quantity Total
Non-Taxable
added 08/10/2020 10:20 AM

$25.00

$25.00 x 1 $25.00
Grand Total
Total $25.00
Payment 08/10/2020$25.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantLAURIE J. SLOMKOWSKI - 08/10/2020 10:20 AM
f1edf269b3e35c151b65863006e90fa5
9a713720aa63a3109e3284554675b029
 
#3 Sign MadeMike Keyport - 08/11/2020 1:18 PM
e996f6ab6ba53aa446081cc6eb1b6744
cf60391150642c109aa478f5cc4d137a
 
Application has been approved. All signatures have been obtained.
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