Emergency Management Physical Address Replacement Application UID # 5470
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 #4919 (08/27/2021)

Charge Cost Quantity Total
Non-Taxable
added 08/27/2021 10:54 PM

$25.00

$25.00 x 1 $25.00
Grand Total
Total $25.00
Payment 08/27/2021$25.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantKarin J. Vanzyl - 08/27/2021 10:54 PM
42e0ab38625dab042b768ce6506d6539
dcb48af1110ff8ffcb457e80f8c3c900
 
#3 Sign MadeMike Keyport - 08/30/2021 3:18 PM
9786903be2ddfcd692eb74c51272158e
4380a40f91a58df47edd780a3ed16b6a
 
Application has been approved. All signatures have been obtained.
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