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f:ITY OF EVERETT <br /> PUl3LIC DISCLOSURE REQU.ST FOR [IVFGRMAT[ON <br /> Phone:(425}257-86I0 Fa:: (425)257-8741 2930 Wetmore Ave.,Evcrett,WA 98201 <br /> S.1 S ner page jor cos[s af capying(Ti1le 42 R.C.W.J � <br /> ., �. <br /> •:^,� <br /> �" ��4 <br /> Requestor's r' � ? <br /> Printed Tiamc: �T l Z �Q C�.y�,S'�� � n�" ^ <br /> � r,�y o� � 2 ., 2 � ;. <br /> ` o <br /> Business Name: �' d— ��` �i'�'� /tj�' � 'Oe� OF �2 <br /> Or',^` y_ <br /> • $1�[33h1tC: 1 i <br /> Address: � g 3 v .����'� e-mail: <br /> Phone No.: �I2 s'3�wJk4�{ Note. Ifyourphone has a block on it we cannot contact yoti <br /> Please contact us aRer 8ve businaas days. <br /> Allow me to: _�ect V�uest a copy of the following reco�ds: Ptease 6e specifia <br /> � <br /> _��/G`���8, o � �u�� �ay� — � I„1�qr}��� <br /> I� <br /> � <br /> _ � <br /> UV <br /> ;.�, C �'J i <br /> If record(::) concem individual(s) other ihan requestor. Please statc. <br /> Is;are the reyucsted record(s) to be used for a commercial purpose'? _Yes �L/ <br /> •', <br />