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CITY OF EVERETT <br /> PUBLIC DISCLOSURE REQUEST FOR INFORMATION <br /> Records Department Phone: (425) 247-8918 Fax: (425) 257-8882 <br /> 3200 Cedar St., Everett, WA 98201 <br /> Date: �"v��'U � <br /> Requestor's ' � � �q �� �,� ��--�� � <br /> Printed Name: �' ` and/or <br /> Business Name: — <br /> Signature: 1 � � <br /> Address:T�,(� �('1'� � �L' ���5 � e-mail: DL'!�l N� �} USf��1��C'ai�c/�ST <br /> �VC-3�l���: (��,�- JB���D �f lC <br /> , , x <br /> Phone No. � �7 � Note: If your phone has a block on it we <br /> cannot contad you. Please confact us a/ter <br /> five business days. <br /> Allow rc�e to: —inspect / y-_ request a copy of the following records. <br /> Please be specific. �U��/ 8� /4�i�n��1� ���/�� �` ��62-{�l��v <br /> If record(s) concern individual(s) other than requestor, piease state. <br /> Is/are the requested record(s) to be used for commercial purpose: _ Yes � No <br />