HomeMy WebLinkAboutOTH Record Requests - 3/27/2007 °• 426 W l"1 Su,PO BOXE 6URDS REQUEST FORM
PHONE(360)427-9670 FAX(360)27-7798601ton WA 84
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would like to information: � � � Requestor's Name Wgs4L V3
Mailed ❑ Faxed ❑ Picked U y
P Address
Date of Request 3 277 o-7 City
St Zip
Time.of Request g;3
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PLEASE PROVIDE RECORDS FOR THE FOLLOWING;
Septic Records ❑ As-Built Only 12 Digit Tax Parcel No.
Other(See Below) ❑ 0- 0
Z 2-
Present Owner Legal Description
Previous Owner
Site Address
Please specifically describe what records or kinds of records you are requesting:
C) 4 Lt
FW 42.17.020 I certify that theinformation obtained through this request will not be used formmercial purposes.
Signature Date
• Large requests may be-charged as provided by RCW 42.17.310. Duringfile review,
You wish to have copied (excluding non-public record documents) must e tagged and cha page's
will be assessed at .15 per page. Copies can be mailed or you may pick them up when ready.
• Copies of blue prints or other large format Items, when available, may be charged a higher rate
per page
Request Routed To: Official Use Onl
❑ PAC File Clerk ❑ County Admin. ❑ Clerk of the Comm.
Other Buildin (❑
Public Works Assessor ❑ Planning ❑ Environmental Health ❑
❑ Auditor Treasurer
Completed by: F-xt c�E�I
Completed date: Records were
I L -� 1
Notes:
Faxed ❑
Cilb m Mailed ❑
To be picked up ❑
Ncs r ec-o- 100 C_�