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EVERETT CTf]'CLERK <br /> 3002 Wetmoce Avenuc <br /> Everett,WA 98201 <br /> (20��`'�-8610 <br /> REQUEST FOR RECORDS <br /> Ondinana 313-74 as amended by Ordinance 1322-87 established a matLad for nquesang copies <br /> oi public records,designated exemptions and provided for fces.These otdinanccs suppon the <br /> concept of public disclosu7z promulgated under Tide 42 RCR'. <br /> 11�e fa is set at S.25 per page.11ris fee is set by tLe Everctt Ciry Cleck ro include costs for <br /> sscacch and copying. <br /> All iequests for public recordc must 1�in writing and provide the following: <br /> ; I <br /> BusinessNume&Add�ess: ��',z!ti. ,��t.,�_�;✓ - <br /> r <br /> Requesro�s Requesro�s <br /> Princed Name: Signanue: <br /> n � " <br /> Address; ��� �7{ C�.'t?-r�,..�c.0 --�-��Phone#. =i �1,�'- -_ � ;"� <br /> ,�, i <br /> � '; <br /> �;��;. ,;� it .v 'J 0-,,:{ = Dace: �.- 5 —`/ <br /> Records Requested: — <br /> • ` FOR OFFICIAL USE ONLY � <br /> Request to: _ Rettivrd by: <br /> Depamnent <br /> Res�.mst Duc Date: , . �.. <br /> Depa-vnent mceiving irquesfi Please attach infortnarion nquested or a statement as ro why tt�e ' <br /> reco-d'u not heing mude available,end retum this rcyucst and the information rcquested,or your <br /> statement of why you an:unabiz to provide the informauon,ro the Everett Ciry Qerk for issu- <br /> ance to the mquestin6 F�Y• <br /> � ACT[ON TAKEN ON F2EQUFST FOR RECORDS�� <br /> lleliven:l:._ lla[c: No.ofPages:_ Cemfied: � <br /> E�emp�_ 75me: No.of Copies:_ Tmasure�s Receipt#:_ ' <br /> Lmployu;s Signsmn: <br />