Crow Wing County

01. Environmental Services 10. E-911 Address App. # 20555, UID # 65415
App. Status: ApprovedCrow Wing County
322 Laurel St. Ste 15
Brainerd, MN 56401

Please attach site plan:

Property Owner Information:

Name:

Clayton Foster

Phone:

(218

) 251

- 6162

Email Address:

claytonkennith@gmail.com

Mailing Address:

Are requesting a new E911 address
or sign/post replacement:

New E911 Address

Charge	Cost	Quantity	Total
Non-Taxable
E911 Address Fee added 05/10/2023 4:57 PM	$100.00	x 1	$100.00
Subtotal			$100.00 0
Grand Total
Total			$100.00
Payment 05/10/2023			$100.00
Due			$0.00

Approval	Signature
Applicant	Clayton Foster - 05/10/2023 4:58 PM - witnessed by Tamra K. Perleberg 44b7e66bc806cffad453f705944fa652 1c2756635e003da6b6b27dffac3a7dd4
#1 GIS Specialist Reviewed & Assigned	Maggie Young - 07/18/2023 10:11 AM 20a9c8cdc8116fc7a4f1834a61a9e46e 62ef9ff5eca7aa699dbfe75ee8d8101e
#2 Blade Created	Tom Strack - 07/19/2023 7:50 AM 395b3cb9b7a728a88bef7bade72b5687 099092b5f5b1c5477618a9f32062fe77
#3 Flagged for Locate	Tom Strack - 07/26/2023 3:56 PM 0c2aea487803389d8273ec6ec897c7ee 0cd08beaa22cc67c596743742620c6ad
#4 Installing	Tom Strack - 07/26/2023 3:57 PM b69db108d20039a845d801a683d93401 82c9958d4c9fde3e7bb35f7b67a15280
#5 Sign Installed	Tom Strack - 07/26/2023 3:57 PM b50ffa8d4046c4d16572d69258c2e63b a2342f39232a6e2ec9a5c5df9f366915

Application has been approved. All signatures have been obtained.

Text:	TRACT A - NEW PID TBD 34212 Peoria Rd Pequot Lakes, MN 56472 Ideal Twp
File(s):	File 1: 20230626_121411_1.jpg File 2: 34212_Peoria_Rd__68310552_TractA.pdf