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CITI' OF EVERETT <br />PUI3LIC DISCLOSURE REQUE5T FOR INFORMATION <br />P6uur. (425) 257-86IU Fax: (425) 257-R741 2930 Nchnorc A�•c., Everett, R'A 98201 <br />S. l.i per pc���e Jnr cn.ct.r uf co/�ring (Trde 42 11.C.If�.) <br />Rcqucstor's <br />Printcd Namc: �[�j��C �_jV� illL 5(`)A(_ and/or <br />T3usincss Na.nu: <br />Signattu'c; <br />.._ ,,�r��s: . �•4 ► � �p `�i" 5 F <br />--,— <br />_�1l�Ti� _ <br />Phonc T�o.:42�_ 2r�_ 29%] Notc: If your phonc has a block o�� it wc cannot coutacl you. <br />Plcasc contact us aflcr fivc busincsc days <br />Allow nre to: _ inspcct _ rcqucst a copy of thc follo���ing rccords: Plcasc bc specific. <br />.I G.� � G , • � rY ! <br />�'1-N�Z"LZ_(.�� 1G'�1� —�-�l-I-- <br />If mcord(s) conccrn indi��idual(s) othcr �han rcqucs:or. Pleasc statc. <br />I;'arc the rcyucstcd record(s) to bc uscd Ibr a comn��rcial purposc'? _l'cs �No <br />