e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 6261
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

Phyllis Parker

Phone:

(218

) 387

- 1183

Email Address:

phyllisparker1084@gmail.com

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
52-258-0050	1084 DEVIL TRK RD		3	62	UNORG RGE 1W	26	1	DEVIL TRACK	USEM SAMUEL L-KATIE A	USEM SAMUEL L-KATIE A

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 05/25/2022 4:04 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 05/25/2022			$25.00
Due			$0.00

Approval	Signature
Applicant	Phyllis E. Parker - 05/25/2022 4:08 PM 9411b0cf9e2e7cc7fe559912a6009722 5052cea7b61d65c6d0746b22068e6fda
#3 Sign Made	Mike Keyport - 07/11/2022 1:10 PM d10609d155318269bcd9148703f3a572 213c79c8d89cda5010ede1a184782e77

Application has been approved. All signatures have been obtained.