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CITY OF EVERETT <br /> PU6LIC DISCLOSURE RF,QUEST FOR INFOItMAT10N <br /> Phonr. (425)257-8610 Fax:(�25)257-8711 2970 Welnare Ave.,Everetl,WA 98201 <br /> $.!S per pu,�c jor rosr.r ojcopyittg (Title 41 R.C.W.) <br /> Requcstur's <br /> Printed Namc: �_ and/or <br /> — ,J <br /> Business Name: ti�IP... � /��✓U ��� �f <br /> Signature:_ <br /> Address: � �" 2 �`..`�G/R//p^ �v P o-mail: ��w-,N��i•l-wer Uw. �o.•• <br /> �r �«�t lv� 5'�'a-a � <br /> Phone No.: ��i a'S�"�/�/�y Note: If your phone has a block on it we cannot contact you. <br /> Piease coatact us after five business days. <br /> Allow me to: �nspect _request a copY of the following records: P�ease be spa(Rc. <br /> 1v ,� /-/�P�•,-��1`f�ci� � v�s�.a—� �l/�' <br /> If ircurd(s� cunrcrn individual(s) olha th.m rcyuos�ur Plr.i;r ;i.dr <br /> Is/arc Uic rcyurs�r�l iccurJ(s) lo bc uscJ for a commcrci�il puip�,�r'' _ 1'cti No <br />