Emergency Management Physical Address Replacement Application UID # 6033
App. Status: Approved
Mike Keyport
218-387-3059
mike.keyport@co.cook.mn.us
 

Applicant & Property Information

Property Owner Information:
Name:
Adcomp LLC
Phone:
(801828 - 7947
Email Address:
bphilpot90@gmail.com
Mailing Address:
212 Janalyn Cir
Golden Valley MN 55416
Property Information:
Parcel and AddressSection Township RangeLakeOwner InformationTax Payer Information
Parcel NumberProperty AddressCityDeeded AcresTownship NumberTownship or CitySectionRangeLake NameOwner NameTaxpayer Name
27-340-1160267 CAPS TRLLUTSEN MN2.4562LUTSEN TWP263TAITADCOMP LLCADCOMP LLC

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 #5380 (03/15/2022)

Charge Cost Quantity Total
Non-Taxable
added 03/15/2022 10:20 AM

$25.00

$25.00 x 1 $25.00
Grand Total
Total $25.00
Payment 03/15/2022$25.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBrittany A. Philpot - 03/15/2022 10:20 AM
5fc464f290dc945028db7da8594732f5
13ac4419cd456dc1e216b91e15abe0d0
 
#3 Sign MadeMike Keyport - 03/15/2022 1:23 PM
b47497bef7db4afffeb6b46311ea1c3a
21addb5f40de34bb58312e00d89b411b
 
Application has been approved. All signatures have been obtained.
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