e-Permitting - Cook County, Minnesota

Emergency Management Physical Address Replacement Application UID # 8738
App. Status: ApprovedMike Keyport
218-387-3059
mike.keyport@co.cook.mn.us

Property Owner Information:

Name:

Jean Skinner

Phone:

(218

) 340

- 8182

Email Address:

tom@lutsen.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
27-121-4450	67 EAGLE MTN LN		5	60	LUTSEN TWP	21	3		SKINNER JEAN D	SKINNER JEAN D

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 12/14/2023 12:30 PM $25.00	$25.00	x 1	$25.00
Subtotal			$25.00 0
Grand Total
Total			$25.00
Payment 12/14/2023			$25.00
Due			$0.00

Action: Print

Approval	Signature	Options
Applicant	Tom Rider - 12/14/2023 12:31 PM 6f6517d35c3948f28377a9a1e0586041 c1af94e851a92484837aa97e0efd4115
#3 Sign Made	Mike Keyport - 12/19/2023 10:25 AM 962fba606ff95f0aea711efbce48b99f 166f17f36f93cc4ba29e44f76d6c7670

Application has been approved. All signatures have been obtained.