Emergency Management Physical Address Replacement Application UID # 5756
App. Status: Pending Review
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 #5191 (11/02/2021)

Charge Cost Quantity Total
Non-Taxable
added 11/02/2021 3:03 PM

$25.00

$25.00 x 1 $25.00
Grand Total
Total $25.00
Due$25.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantTala J. Marxen - 11/02/2021 3:05 PM
8e3ee8aec26d63781c272d7e9fbe0ca5
de4f1bb5391f6f0823978b3af59705ab
 
#3 Sign Made 
You do not have the necessary rights for this signature
Application will be approved after the above signatures are obtained.
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