HomeMy WebLinkAboutOTH Record Requests - 3/25/2009 --- Mason County Public Records Request Form
426 W. Cedar Street, PO Box 186, Shelton WA. 98584
Phone: (360) 427-9670 X-352 Fax: (360) 427-7798
I would like information: Mailed Faxed_ icked U ate: 3 cc?
Requesters Name: J r0
Company Representing: ��
Address: 2�J I C/ // I Y / ///i(/� LoZ Etrmtf: S- tC t `/ D
City: /--- -JJ2CLIzLc_ State: Zip: g A9 l9
Phone3cfc/ _ V(p0 77 N Fax:
Parcel No. D 3 - Iq- � a
Parcel Address:
Owner: Previous Owner
Please Provide Records For The Following:
Environmental Health Planning Dept. Building Dept
Please specifically des the what records or kind of r cords you are requesting:
(/ 7eea
RCW 42.56 1 certify that the information obtai om this request will not be used for
commercial purposes. Signature Required: Pr--
Requests may be charged per RCW 42.56. During file review any pages you wish to
have copied ( excluding non public record documents) must be tagged and charges will
be assessed at .15 cents per copy. Larger than 8.5"x 11" will be charged at a higher rate
as established by Mason County resolution.
In addition to the per copied page fee standard postage rates will apply.
Make Checks Payable To: Mason County Treasurer; Total Fees Due:
Official Use Only n
Completed By: Ext. )4 Date: � -/
Notes:
*Please allow 5 business days for us to respond to your request*
if items are being mailed please allow an additional 3 days until you receive the request submitted.