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CITY OF EVERETT <br />YUL3L[C DISCLOSURE REQUEST FOR INFURMAT[ON <br />Phooc: (t2� 257-8610 Fas: ;425) 257-8741 2930 Wetmore Ave., Everett, WA 9820! <br />S. !S per page jor costs ojcopying (7'i1/e 41 R.C.W.J <br />Requestor's <br />Printed I�amc: � <br />Business Name: <br />and/or <br />• Signantr . �i�,c�--�z� <br />Address: _��D� /(/Q SSi/ /� �� o-mail: �io a n Ca�. B k�. M 1� <br />� �� ��� , �� �- y� � � - <br />Phoae No.: 4aS � S`r -I �i s� Na�e: If your phone hss a block on it we cannot coatact you. <br />Picase contact us after five busiaess days. <br />AlIow me to: _ inspect ✓ requesi a copy of the following records: P[ease 6e specific <br />If record(::) concem individual(s) other than requestor. Please state. /�py T oi�;�,; J7> OUv' /`DIY� <br />Islarc the rcyucsted record(s) to be used for a commercial purpose? _Yes ✓No <br />, �� <br />� � � CO �v� q.,L <br />