e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 5112
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

John and Nancy Koloski

Phone:

(218

) 663

- 0147

Email Address:

nancykoloski@gmail.com

Mailing Address:

Property Information:

Parcel and Address				Section Township Range				Lake	Owner Information	Tax Payer Information
Parcel Number	Property Address	City	Deeded Acres	Township Number	Township or City	Section	Range	Lake Name	Owner Name	Taxpayer Name
25-053-0106	41 OVERLOOK TRL		2.04	59	TOFTE TWP	14	4		KOLOSKI NANCY I-JOHN P TRUSTEES	KOLOSKI NANCY I-JOHN P TRUSTEES

What is your currently assigned Address number?	41
What is your currently assigned Street Name?	Overlook Trail
Do you have more than one missing sign?	Yes
Please indicate how many signs need to be replaced:	1
Do you need a replacement sign post?	No
Please indicate how many posts need to be replaced:	0

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

Charge	Cost	Quantity	Total
Non-Taxable
Physicsl Address Replacement Application Fees added 06/18/2021 1:08 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 06/18/2021			$25.00
Due			$0.00

Approval	Signature
Applicant	Nancy Koloski - 06/18/2021 1:10 PM 010ef1647a14970d0a7c9c4598421547 ae7391332f7506ca36c6832c35dac71b