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-;�. <br /> EVERETT CTTY CLERK _ <br /> 3pp2 Wetmo�Avenue <br /> Everett,WA 98201 <br /> (20�259-8610 <br /> REQUEST FOR RECORDS <br /> Oc,dinancx 313-74 as amended by Ocdiaance 1322'8�°stablished a method for requesting copies <br /> of public iecords,designaud exemptions and provided for fees.These oidinances support the , <br /> concepc of public disclosure promulgatcd under�de 42 RCW. <br /> The fa is set at$.25 per page.This fee is set by the Everett City CIe3c to include cosu for <br /> izseaich and copying. <br /> All requests for public izcords must be in writin8 and Pr°v�de�°following: <br /> Business Namc &Address: <br /> Reguesto�s Requesto�'s /� � r��s,u�J�` <br /> i / <br /> Prinud Name• �1 hf�f `r)1'P�/�Yi:� � _Signatuce' <br /> � �,�� -9,�?� <br /> Address•._.t,;:� �� ���'—Y� . Phone#: <br /> ri �r <br /> }1'" v'q." %�� '?L'� Date• I — I�� —C( >> <br /> l�:r� i ,' L� �� „_� <br /> l� � -� '�-la- ._� � <br /> Records Ttequesud: <br /> ,_-- , <br /> . _ ,-______________-_____�.------------ ; , ' <br /> ' ', FOR O�'ICIAL USE ONLY .: ; <br /> Rrqaest to � ' V ' Ftece�ved by <br /> , ,. ,.. Department ; = ; <br /> Y..: 1 3 <br /> ^ � a <br /> � i. <br /> gesponsz pue Dace ` ' ; � , ' � <br /> � ` : `' <br /> . ` cs�PkBse attach u�fc�emaaoB�4��edbrs.§tatemeni as m why,shc <br /> I7epaciment�vuig neqa i and the���lnested,o;Ya�r <br /> ncordasuottxFngmadeavaitatile, andretumthu'zequ�s <br /> •."statemeutof:whyyon"�re unable tn pravide the infotmarion;tQtha�verettCiry Clcrk�orAss� <br /> ance to the ztquestin8 F?�?Y <br /> ACTIUN'i'AKEPf ON REQ'[7EST FUR RECORDS ° ` <br /> ' Na ofPages � � ����� <br /> DeTivaed� `� Dau��:1�-� ,. . <br /> EzemP� Time. <br /> �' .�� . I�Ia.of Copies:.,.:�.._. `I'��s Rece�pt#;:i��.t'� . <br /> , " �- <br /> , . ���� � <br /> EmpIoyee's Signawre �� � � '-'� <br /> 4 <br />