e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 5724
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

Kay K Plank

Phone:

(641

) 423

- 9989

Email Address:

kjp@mchsi.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
27-346-0104	21 BILLIES TRL	LUTSEN MN	1.72	62	LUTSEN TWP	27	3	TAIT	PLANK KAY K	PLANK KAY K

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 10/22/2021 12:13 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 10/22/2021			$25.00
Due			$0.00

Action: Print

Approval	Signature	Options
Applicant	Carl J. Plank - 10/22/2021 12:13 PM 5bc49a8cb3fb8397901e7a58ae825a28 160a0999a92c70eaba707879e62f3cfe
#3 Sign Made	Mike Keyport - 10/25/2021 1:50 PM f5b2f7a5797876556fe2376d8c738c18 6f2c98b5f61e1e712d1d413284365a60

Application has been approved. All signatures have been obtained.