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CITY OF EVERETT <br /> PUBLIC DISCLOSURE REQUEST FOR INFORMATION <br /> Phune:(425)257-86�0 I'ax: (425)257-8741 293U�Vetmorc Ave.,Evere[t,WA 98201 <br /> �./i per puge,%ur ru.c�.v u(copYing (Title 42 R.C.W.J <br /> Kcqucs[or's ���� /� /� <br /> Printcd Name: 7 1�P/ � and/or <br /> Business Namc: <br /> Signature: <br /> Address: f ��QC"f—�lC�L�ST��/l .� e-mail: rc��rl a�Ss N ''`�.�lu./G.�.+, <br /> � � �� ^ ,�� 9fL2� <br /> Phone Na: No�e: IFyour phone has a block on it we cannot contact you. <br /> Please contact us after five business days. <br /> Allow mc to: _inspcct _request a copy of the following records: P►ease be specific. <br /> [f record(s) concern individual(s) other than rcquestor. Please state. _ <br /> Is'ur�z thc rcqu�s[cd recurd(s) to bc uscd Yor:i commcrcial putposc'? _Ycs No <br />