e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 5756
App. Status: Pending ReviewMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Applicant & Property Information

Property Owner Information:

Name:

Tala Joy Marxen

Phone:

(218

) 370

- 9044

Email Address:

talajoy13@yahoo.com

Mailing Address:

P. O. Box 674

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
52-228-3430	1033 S SHORE DR		2.08	62	UNORG RGE 1W	28	1	DEVIL TRACK	MARXEN TALA J-BRANDON P	MARXEN TALA J-BRANDON P

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
Physicsl Address Replacement Application Fees added 11/02/2021 3:03 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Due			$25.00

Approvals

Approval	Signature
Applicant	Tala J. Marxen - 11/02/2021 3:05 PM 8e3ee8aec26d63781c272d7e9fbe0ca5 de4f1bb5391f6f0823978b3af59705ab
#3 Sign Made

Application will be approved after the above signatures are obtained.