e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 8555
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

Jacob & Elizabeth Davis

Phone:

(715

) 791

- 4946

Email Address:

elizabethannedavis@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
80-017-4420	910 5 AV W		0.22	61	GRAND MARAIS CITY	17	1		DAVIS JACOB EDWARD E-ELIZABETH ANNE	DAVIS JACOB EDWARD E-ELIZABETH ANNE

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 11/17/2023 3:29 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 11/17/2023			$25.00
Due			$0.00

Action: Print

Approval	Signature	Options
Applicant	Elizabeth A. Davis - 11/17/2023 3:29 PM b15da284aeb466d41a9ea92fa9d64901 8e862973bbdfe1c5519ebf9899b970c9
#3 Sign Made	Mike Keyport - 11/21/2023 11:26 AM d90ca04629a16a45685a67b66c2c5ee8 b0e11292f70d6f241f6689a44aebe74d

Application has been approved. All signatures have been obtained.