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, . . . , � <br /> :�[itWCDtBC�tAlIt�F�Qv�=1�;�'O*#t+�'f"�ON -'�: _ i <br /> eN.n� _ !NlN41�.n Ms i <br /> � <br /> $.IS per pnge for costs of copying (Tide 4: R.C.W.) <br /> Requestor's �+ �:equesror's � ���t� <br /> PrintedName:L��i-�4� ICkI✓1�Signature: <br /> i <br /> Address: 7�Q( � �`i�PArt� 14v'Q- Phone No.:(y2SJ-3V �-59�1� I <br /> Ey�/L�t}, �U A Business Name: I <br /> Allow me to: inspect � request a copy of the following records: <br /> � <br /> (�l o i :— o�,,;-.t ,O,l�d',,�,'�C</t� <br /> �,- � r <br /> If record(s) concern individual(s) other than requcs[or. Please state. ' <br /> Is/are the re.7uested record(s) ro be used for a cammercial purpose? _Yes �No � <br /> Request was made: � In person _By phone _Fax _Mail <br /> Date request received: �J� By (Dept.): Response Due date: <br /> lica le de artment has been notified, and <br /> Allow access. The app � <br /> you may access the requested records. , <br /> Deny access. The City has determined that the records you have <br /> requested are exempt under the law for the <br /> following reasons: <br /> We do not have the record(s). Explanation: <br /> Date Requestor notified: By Mail _ By Phone _ In person _ <br /> I certify that notification of final City respon;e was carried out by me as stated above. <br /> Signature of Notifying Employee: _��� <br /> No. of copies L Certified _ Treas. Receipt ll GL-002 341 6l 00000 <br /> Copy 1 - Clerk's OJjSce Copy 2 -Appropria[e Dept. Copy 3- Requestor <br />