HomeMy WebLinkAboutOTH Record Requests - 11/27/2006 ••• 426 vv a s�,cut; HECURDS REQUEST FORM
CedarPHONE(360)427-7.6770 BOX1 86 FAX(360)27-77g, Shelton WA g4
Please a!!ow S business days focus to res and to your request*
'N kerns are hekq mailed please allow a n additlonal 3 days tam YOU reoefve ffre pa�ervrork
would like to information: Requestor's Name ,J ;
Mailed ❑ Faxed [] Picked Up Address
Date of Request j-2 2. d ,�� City St ��_ Zip
Time of Request _ �- 11 � x9 Phone Fax
PLEASE PROVIDE RECORDS FOR THE FOLLOWING:
Septic Records As-Built Only ❑ 12 Digit Tax Parcel No.
Other(See Below) ❑ — � i $ _ � L4 - � 0 -c) 3
U41
Present Owner ; //. ,<� Legal Description (,,J S " 0 1
r L
Previous Owner
Site Address�7�
Please specifically describe what records or kinds of records you are requesting:
RCW 42.17.0201 certify that the information obtained through this request will not be used for
commercial purposes.
Signature
Date
• Large requests m b char ed as provided by RCW 42.17.310. During file review, an you wish to have copied (excluding nan-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 blue prints or other large format items, when available, tr
era e may be charged a higher rate
Official Use Onl
Request Routed To: PAC File Clerk ❑ Count Admin.
Other ❑ Building ❑ PlanningEl Clerk of the Comm. [�
Public Works Assessor ❑ El Health ❑
Auditor n Treasurer
Completed by: A r ij , Ext Records were
Completed date:
Notes:
Faxed ❑
Mailed ❑
To be picked up ❑