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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: `l � 2 C� -b L� <br /> Requestor's � ;,. <br /> Printed Name: ��"�' ��� f�� � «�� �: Cr _ and/or <br /> Business Name: <br /> 7 <br /> Signature: ��1�'�U-�L����,� <br /> Address: �' � z r > �l����-L f�� e-mail: <br /> L-�1 ��z��`T , l,l�A � ��� 1 U � <br /> Phone No. Note:If your phone has a block on it we <br /> cannot contad you. Please contact us aRe� <br /> five business days. <br /> Allow me to: —inspect / X request a copy of the following records. <br /> Please be specific. C L� I� IZ-C�T �� C� ��C-, ��� l� G iU <br /> �`�;O � `i'1-l[� IZc R�� <br /> If record(s) concern individual(s) other than requestor, please state. <br /> Is/are the requested record(s) to be used for commercial purpose: _ Yes _ No <br />