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( <br />CITY Or EVERETT <br />PUaLIC llISCLOSUI2L" R�QUEST I'OR [NrOlL1�[A"C[On` <br />Phonc:(4251257-8610 <br />Fsx: (425) 257-8741 2730 Wclmore Avc., Evcrctl, R'A 98201 <br />S.1 S per page jor cosls of copying (Tirle d2 R. C, {V.1 <br />P�equestor's �� , <br />Printed A�ame: •'ltl rY� � C�`�1 _ and/or <br />Business Tiame: <br />Signature: �'�r(�;�= � _ <br />Address: j u l l �.io. .%U� �i�.�,k '�✓. e-mail: <br />EV'f , i,JVa ����Z,cJ `� <br />Phone No.: �5 2-(� S�i � Note: Ifyour phone has a block on it we a�nnot contact you. <br />Pleasc contact us a(ier five business days. <br />��h« '�FZS-717-�?�.��� <br />Allow m<: to: _ inspect _ request a copy of the following records: Piease be specific <br />If record(�:) concem individual(s) other tl�an req���stor. Pleasc state. <br />Is�are the requcsted record(s) to be used for a commercia( pumose? <br />_Ycs _No <br />