e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 6191
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

Nancy Jo Lang

Phone:

(218

) 370

- 5932

Email Address:

bellevie@boreal.org

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
54-226-1250	55 FRANKS WAY		10.02	62	UNORG RGE 2E	26	2		LANG NANCY J	LANG NANCY J

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 05/08/2022 4:29 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 05/08/2022			$25.00
Due			$0.00

Action: Print

Approval	Signature	Options
Applicant	Nancy J. Lang - 05/08/2022 4:36 PM 38e2e5cdb8453786eff763a5f848a976 570762b1c05b96437e8f6e0965c80d41
#3 Sign Made	Mike Keyport - 05/10/2022 10:24 AM dafd281f4928c22095d53eb2771a9a26 38f117fa1b6527d0e44685b6a542e727

Application has been approved. All signatures have been obtained.