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� r � EVLRL-TT CITY CLERK <br /> p � � 3002 Wetmore Avcnuc <br /> c � Everett,WA 98201 <br /> � � _ (206)259-5610 <br /> H �+ <br /> � y A <br /> � � � REQUEST FOR RECORL'� <br /> y M <br /> 1° .°3 � prdinance 313-74 as amended by Ordinance 1322-87 established a method for requesdng copies <br /> zm � of public iecords,designated exempdons and providcd for fces.These ordinances support the <br /> _ � � concept of public disclosure promulgated under Tide 42 RCW. <br /> y <br /> o y � � The fee is set at 5.25 per page.This fee is set by the Everett City Clerk to includc costs for <br /> �i o v, ieseaich and copying. <br /> a� ea r <br /> � o v�'i All mquests for public records must be in w'riting and provide the following: <br /> Business Name&Address: <br /> �3a7 n�� kz�- (1,��,���•_� <br /> Requestar's R uestors 1 <br /> � �/���I�u��� 4�"l,n,��— <br /> Printed Name: ���I C ��'l�l-C• �Lti(��t� Signamie: � <br /> � � <br /> '� �j�JD� (��r-�GC� Phone#: �S�- 5 �� � <br /> � Address: <br /> ', �1/�.K.�u.� � '��� _ Date: 2 I:-5�� I <br /> i��' Records Requested: ��l0 1'{ i�r✓� /'i,�-���'�� ' �'30 0 .��–.0_.�.�r-.�r.�, <br /> _ J <br /> � � <br /> � <br /> � �� � <br /> ' - ------------------------------- <br /> � - - -- <br /> -------------------------------- -------- ----•---- -- --- - <br /> r'�� : FOR OFFICIAL USE ONLY <br /> , <br /> : � <br /> Request w: �' '� — Receive3 by: ✓_.,_s��f. . . ° <br /> I, �� Departrncnt <br /> (�.1— Response Due Date: <br /> Departinent recciving requcst: Ple;�se attach infonnation requested or a statcment as to why thc <br /> � record is not being made availabie, and return this request and the information mquested,or your <br /> � � statement of why you are unable to orovide the infonnation,to tl�e Everett Ciry Clerk Cor issu- <br /> ance to the cequesdng pany. <br /> ------------------------------------------------- <br /> ------------------------------ <br /> -------------------- <br /> I -'�' � ACTION TAKEN ON REQUEST FOR RECORDS �'a t S.— <br /> � Dclivcrcd:� Datc: 3 �s'i s No.of Pagcs:9 Ccrtificd: <br /> Ezempt: <br /> Time: No. ofCopies:_ Treasurcc'sRecaipt#c..YyS"� <br /> L•mployee'sSignawre: �'---� ' ' <br />