e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 5399
App. Status: Pending ReviewMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Applicant & Property Information

Property Owner Information:

Name:

Joann Johnson

Phone:

(714

) 292

- 5280

Email Address:

tcarterhb@gmail.com

Mailing Address:

PO Box 880

Grand Marais	MN	55604

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
53-122-2140	1460 OLD SHORE RD		3	61	UNORG RGE 1E	22	1	LAKE SUPERIOR	JOHNSON JO ANN TRUSTEE	JOHNSON JO ANN TRUSTEE

Project Information

What is your currently assigned Address number?	1460
What is your currently assigned Street Name?	Old Shore Rd
Do you have more than one missing sign?	No
Please indicate how many signs need to be replaced:	One, Green, request to be Attached with two others on post
Do you need a replacement sign post?	No
Please indicate how many posts need to be replaced:	none

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 #4845 (08/12/2021)

Charge	Cost	Quantity	Total
Non-Taxable
Physicsl Address Replacement Application Fees added 08/12/2021 6:06 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 08/12/2021			$25.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Leslie Carter - 08/12/2021 6:06 PM 4b898614e7e820dc800f51c7662cd1be 304275da35efc485086599dadc20622f
#3 Sign Made		You do not have the necessary rights for this signature

Application will be approved after the above signatures are obtained.