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CITY OF EVERETT <br />=(425) <br />C DISCLOSURE REQUEST FOR INFORMATION <br />Fax: (425) 257-8741 2930 Wetmore Ave., Everett, WA 98201 <br />Requester's <br />Printed Name <br />Business Name: <br />$. /5 p, - page for costs of copying (Title 41 R.C. IV) <br />7;7ZiWi I <br />Signature: <br />Address: � z c-mail• <br />and/or <br />Phone No.: t r3r9-�e Note: If your phone has a block on it we cannot contact you. <br />Please contact us after five business days. <br />Allow me to: _ inspect `� rCgnest a copy of the following records: Please be spe . <br />94r a . e/ f �� 3/6 "Or. &C- _ <br />Ifrecord(s) concern individual(s) other than requester. Please state <br />Is/are the requested record(s) to be used for a commercial purpose? <br />Yes _�/No <br />