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CiTY OI+'BVBRBTT <br /> MJrLtC bI8C1,0AUlU� RIEQURA7'F'OR iNl+O�MA1'ION <br /> Rar+tlfh l67�ii� J�3 Mri1M�e Ave. <br /> S.IS per page for costs oJcopying (7'irle 41 R.C.W.) <br /> Requesror's Requesror's <br /> Printed Name: u i Signature: ���� <br /> � Yj�- <br /> Address: 6 �P6o� No.: �� ;-OY9�/ <br /> Dusiness Namr._�I�c � ��� <br /> Allow me to: inspect ✓request a copy of the followin records: <br /> �zOG� /O� �� J�T,r� - e?i1.�.4� �is. /1r..� v.uB <br /> �'T <br /> If record(s) concern individual(s) other than requestor. Piease state. <br /> ls/are the requesled record(s) to be used for a commercial purpose'? ✓Yes No <br /> Request was made: �n person _ py phone _ Fax Mail <br /> Date rcquest received: _��"_`t_" By (Dept.): � Response Duc date: <br /> _ Allow access. The applicable department has been notified, and <br /> you may access the requested records. <br /> Deny access. The City has determined that the records you have <br /> requested are cxempt under the law for the <br /> following rcasons: <br /> We do not have the record(s). Explanation: <br /> Date Requestor notified: �9 By Mail _ By Phone _ In person � <br /> I certify that notification of final City response was carried out by me as stated above. <br /> Signature of Notifying Employee: <br /> No. of copies � Certified _ Treas. Receipt N GL-002 341 61 00000 <br /> Copy 1 - C/erk's O/jice Copy 2-Appropnnfe Dep�. Copy 3 � Requestor <br />