Laserfiche WebLink
1 <br /> I <br /> I <br /> � <br /> ' <br /> i <br /> R�QU�ST FOR RECORDS <br /> CITY CLERK' S OFFICE j <br /> EVERETT, I�ASHINGTOti • <br /> Print � � � <br /> Na�e fi/ ` lQ Signature�TJ ��� lG,� <br /> Address . V� y���/ � <br /> / // �� Q // Telephone /� �,) Q� I <br /> S�c.l�f��L�.�'i / ��7' 6 Number �(% 2 t_ � <br /> Records / ,� aer.ti,��J L�b/�¢ y,�Z<'� (r����ur✓ <br /> Requested �Cins ' <br /> Request \ � •����-� Time+ � <br /> Recvd. by Date _��_��_ <br /> • • " gn ture • <br /> * * Request • Received <br /> • fon�.�arded to By. • I <br /> DeparUnent <br /> ** Response Due Date • I� <br /> i <br /> ** Department receiving the request should attach information requested �il <br /> or a statement as to why the record is not beinq dispensed and I <br /> return to the City Clerk for issuance to requestor. (Ord. 313-74) <br /> I <br /> ACTION TAY.EN ON RECORD I <br /> REQUEST <br /> Delivered Date No. Pages Certified <br /> Exempt Time No. Copies <br /> Attachments Em�loyees Sign. <br /> I <br />