HomeMy WebLinkAboutOTH Record Requests - 11/2/2006 11/06/2006 15:30 FAX 360 427 7798 MASON CO PERMIT CTR Q 001
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L. Luu0 t_ulrm WINULWHE /HIMLIE_�- - --- ---- -_---• N0 2643 - P. 1/1
MASON COUNTY PUBLIC RECORDS REQUEST FORM
426 W Cedar St, F0 BOX 186,Shelton WA 9t3584
PHONE(360) 427-9670 FAX(360)427-7798
_Please allow 5 business daVs for us to respond to vour request*
V ilam am being maUed please allow an addlllalet 3 days W01 you receive the paperW0*
1 would like the information: Requestor's Name ij Iff
Mailed ❑ Faxed ET Picked Up ❑ Address � e,I j1
Date of Request nj ,�-/1 City 9himo, St zip q, m
/ NXP_MJ0 Fax Q P 0— /r —
Time of Request � , �-{�j .Phone
PLEASE PROVIDE RECORDS FOR THE FOLLOWING:
Septic Records [ As-Built Only ❑ 12 Digit Tax Parcel No.
Other(flee Below) ❑ '�j Z , ?�� - _ (� 3 '
Present Owner � Legal Description (J�
Previous Owner 1 �cl `, O LS 1/ '�-tO
Site Address
Please specifically describe what records or kinds of records you are requesting;
G
bj
• RCW 42.17-0201 certify that the information obtained through this request will not be used for
commercial purposes.
Signatur Date
• Large requests may arged-as provided by RCW 42.17.310. During fine review, any pages
you wish to have copied (excluding non-public record documents) must be tagged and charges
will be assessed at .15 per page. Copies can be mailed or you may pick them up when ready.
• Copies of blueprints or other larcie fiormet items_when availabrP. may hp ithmmArl a hirihAr m+a