e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 6325
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

Dan Skokan

Phone:

(515

) 778

- 0994

Email Address:

danskokan@outlook.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
50-440-0204	8 BLACK SPRUCE TRL		2.6	64	UNORG RGE 3W	2	3	TUCKER	STRUVE MATTHEW P-JAMIE L TRUSTEES	STRUVE MATTHEW P-JAMIE L TRUSTEES

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 06/08/2022 6:53 AM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 06/08/2022			$25.00
Due			$0.00

Action: Print

Approval	Signature	Options
Applicant	Dan D. Skokan - 06/08/2022 6:54 AM 372cce591820496ffe533c2b0478ffae ebeb350949da1b23be172eb17625a887
#3 Sign Made	Mike Keyport - 06/14/2022 11:43 AM 7ca39acc6e5b600d5e9c0bdc095c48bb 1a095ff54dca24cf6910eb01c01eed91

Application has been approved. All signatures have been obtained.