Emergency Management Physical Address Replacement Application UID # 5111
App. Status: Approved
Mike Keyport
218-387-3059
mike.keyport@co.cook.mn.us
 

Applicant & Property Information

Property Owner Information:
Name:
Vonda Van Dyk
Phone:
(651253 - 3218
Email Address:
vonz02@yahoo.com
Mailing Address:
12728 Ethelton Way
Apple Valley MN 55124
Property Information:
Parcel and AddressSection Township RangeLakeOwner InformationTax Payer Information
Parcel NumberProperty AddressCityDeeded AcresTownship NumberTownship or CitySectionRangeLake NameOwner NameTaxpayer Name
55-231-34206 KELLY RIDGEGRAND MARAIS MN562UNORG RGE 3E313VAN DYK VONDA-MAGER JODI MVAN DYK VONDA-MAGER JODI M

Project Information

What is your currently assigned Address number? 6
What is your currently assigned Street Name? Kelly Ridge Road
Do you have more than one missing sign? No
Please indicate how many signs need to be replaced: 1
Do you need a replacement sign post? Yes
Please indicate how many posts need to be replaced: Mike stated would bring a new post

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 #4562 (06/18/2021)

Charge Cost Quantity Total
Non-Taxable
added 06/18/2021 12:31 PM

$25.00

$25.00 x 1 $25.00
Grand Total
Total $25.00
Payment 06/18/2021$25.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantVonda Van Dyk - 06/18/2021 12:31 PM
38bb518adf2195a6209d0b737a112c93
2250d87b961dbf41e6b4915efc77089d
 
#3 Sign MadeMike Keyport - 06/22/2021 9:42 AM
3a42903aca0732231cb3898b11937951
3c8664eb595df2e313221d9c522d28c3
 
Application has been approved. All signatures have been obtained.
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