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EVERETT QTY CLERK <br /> 3002 Wetmore Avenuc <br /> Everett,WA 98201 <br /> (20�259-8610 <br /> REQUEST FOR RECORDS <br /> prdinance 313-74 as amended by Ordinance 1322-87 established a method for rcquesdng copies <br /> , of public tscords,designated exempdons and provided for fees.These ondinances support the , <br /> concept of public disclosurc promulgateci under Tide 42 RCW. <br /> The fee is set at 5.25 per page.This fee is set by the Everett City Cledc to include costs for <br /> isseazch and copying. <br /> All requesu for public records must t�in wricinB aad Pr°'^de�e following: �'��� <br /> / �sy�o m�u P,P��'.d'�dD <br /> Business Name&Address: <br /> S o.11 ��vE�f/lJ.�/ �cc P� A vi7_ <br /> /� , ��� ;; <br /> Requesto�s Requcsto�s <br /> Princea Name:�'�1'�' v9✓�D ,�f�.uD�✓� � s;gnanuc: <br /> S`Jm`� Phone#: 7��1� <br /> Address: � <br /> ' Date: ��6�9,5� _ <br /> � / <br /> , Records Requcsted: / �' � (,� <br /> • ��f --�-- <br /> _ __—_____-- ---- -- <br /> �ox o�rrcrnL usE orrLv , <br /> Requcst to:�� ' Receiverl by: -=--- . I <br /> Depa ent i <br /> Response Duc Dnte:�` tn � � —�-��-� I <br /> j7epartinent receiving requesf: Please attach inform:uion rrs3nestc;d cu'a statcment as to why.die <br /> record is noc being made availa6le, nn�l return this rcyucst and ihe information�quested, or yo�u <br /> statement of why yoo sre unable to pravide dic infomiation,to ihe Everett C�r,�Gerk for issu- <br /> `nce to the requestinS P�Y• <br /> y ACTIdN TAKEi� �N K�QUEST FUR RF:CORDS <br /> Delivered:;` nft:�• <br /> No. of Pages: Certificd:__ <br /> , Fccmpt. T.me;__ <br /> No. of Copics____.__ "r�sure's Re::eipt il' <br /> Employec's Si�;natun: _ -- --- —-- <br /> _ ...._.. <br /> �.._... <br /> _ _ 1 <br />