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CITY OF EVERETT <br />PUBLIC DISCLOSURE REQUEST FOR INFQRf�IATION <br />Records Department Phone: (425) 247-8918 Fax: (425) 257-8882 <br />3200 Cedar St., Everett, WA 98201 <br />,/ <br />Date: _,1 �/ � -�; - - <br />i 1 <br />Requestor's � /`/z C' � y <br />Printed Name: <br />Business Name: <br />�- <br />Signature: ��' <br />and/or <br />Address: __� ���'l1 C i�� l /./�''�_ e-mail: �rn��.�ko�� i1//2c��'�Cc9FL,. <br />/ i/ <br />_ � ' �' �,2�1� � � � �z C'L- <br />� �` ` �. L <br />Phone No. ��1� `� �� ��� � --- Note: If your phone has a block on it we <br />^ cannot contact you. Please contact us aRe� <br />five business days. <br />Allow me to: <br />Please be specific. <br />% �/h"> <br />--inspect /-�— request a copy of the following records. <br />�1, _ . -,� i i % / : � � '? /� _ <br />i �, -ix�� <br />If record(s) concern individual(s) other than requestor, please state. . � <br />Is/are the reyuested record(s) fo be used for commercial purpose: _ Yes �� �No <br />