Emergency Management Physical Address Replacement Application UID # 5724
App. Status: Approved
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 #5158 (10/22/2021)

Charge Cost Quantity Total
Non-Taxable
added 10/22/2021 12:13 PM

$25.00

$25.00 x 1 $25.00
Grand Total
Total $25.00
Payment 10/22/2021$25.00
Due$0.00

Approvals

ApprovalSignature
ApplicantCarl J. Plank - 10/22/2021 12:13 PM
5bc49a8cb3fb8397901e7a58ae825a28
160a0999a92c70eaba707879e62f3cfe
#3 Sign MadeMike Keyport - 10/25/2021 1:50 PM
f5b2f7a5797876556fe2376d8c738c18
6f2c98b5f61e1e712d1d413284365a60
Application has been approved. All signatures have been obtained.
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