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�_, , <br /> �: � <br /> EVERETT CiTl'CLERK I <br /> 3002 Wetmoce Avenue <br /> Everett,WA 98201 , i <br /> (206)259-8610 , <br /> yC� <br /> ��x REQUEST FOR RECORDS � <br /> _ , <br /> 9HV~i <br /> � Oc,dinance 313-74 as amended by Qrdinance 1322-87 established a methal for iequesting copies <br /> � x� of public recoids,designated exempdons and provided for fees.These ordinances support the I <br /> o x o concept of public disclosure pmmulgated under Tide 42 RC1V. <br /> 3 y C' <br /> The fee is set at$.25 per page.Ttns fee is set by the Everett City Clerk to include costs for <br /> h y d iesearch and copying. <br /> o F-+ <br /> ��g All requests for public records must be in writing and provide the following: <br /> 9H�t� � Business Name&Address: ! <br /> HH I <br /> gd y Requestoc's �ANc L� c Requesta�s��o GQ`� ��%'���J <br /> � �� Printed Name: r`CNU7��0/I/ Signature:�� ' <br /> y o` Address: �90-7 Cr'2,L� e�z. ��� Phone#: ,�CG!>�fd�-� <br /> ' �,L(�,�G� �, /9 9� � <br /> Date: <br /> /��'m i A fo.e�m /Ya / 9c I <br /> Records Requesteci' � p <br /> �_ ' L �ii� r��'' 79�J �'2d� .4.t�a iL�i '� <br /> �� <br /> ..v,� <br /> -------------------------------------- <br /> ��:. �j • <br /> FOR OFFICIAL USti ONLY , <br /> ' � � Request to:_ Received by: , <br /> !.� � Depa�anent ' <br /> ...� <br /> Rcsponse Due Date: <br /> �"�1 Departinent c�ceiving request: Please attach infonnation requested or a sqtemenc as to why d�e <br /> record is not being mnde available, and retum this rcqurst and the information requested,or your <br /> O`Q'�� sra[emen[of why you �.re unabie to provide the information,to the Everctt City Cierk for issu- <br /> ance to the requesting panY• <br /> ---------------------------------------------------------- <br /> � ^�� ACTION TAKEti ON RP:QiJEST FOR RECORDS <br /> Dclivend:✓� Date:y�Z� No. of Pages:�_ ��fi�� <br /> Ezempt: 7ime: No. of Copies:_ 'rnasurer's Receipt#: ' <br /> Employc�s Signamn;: <br /> _ _ _ . _ __ _ _ . <br />