HomeMy WebLinkAboutOTH Record Requests - 6/29/2007 (2) 06/29/2007 FRI 12: 59 FAX 14001/001
MASON COUNTY PUBLIC RECORDS REQUEST FORM
426 W Cedar St, PO BOX 186, Shelton WA 98584
PHONE (360)427-9670 FAX(360)427-7798
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 paperwork
I would like the information: Requestor''s Name MAd 0 1�Wv (,ion
Mailed ❑ Faxed Ef Picked Up ❑ Address
Date of Request Z� • City St Zip
Time of Request (� , �� -A-PA Phone G�q�• (Q � Fax �Z 7_1 OD
PLEASE PROVIDE RECORDS FOR THE FOLLOWING:
Septic Records E As-Built Only ❑' 12 Digit Tax Parcel No. q
Other (See Below) ❑ 2 - �, - -I 0 Q
Present Owner Legal Description
Previous Owner W
" 0/--
Site Address 8 I I U q
Please specifically describe what records or, finds f records you are requesting:
I r��-h
• RCW 42.56. I certify that the information obtained through this request will not be used for commercial
purposes.
SignatureMJ14-�lV\j
Date
• Large requests may be arged as p vided by RCW 42.56. During file review, any pages you with to
have copied (excluding non-public r cord documents) must be tagged and charges will be assessed at
.15 cents 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
Official Use Only
Request Routed To: PAC File Clerk ❑ County Admin. ❑ Clerk of the Comm_ ❑
Other ❑ Building ❑ Planning ❑ Environmental Health ❑
Public Works ❑ Assessor ❑ Auditor ❑ Treasurer ❑
Completed by: � ) Ext Records were
Completed date: --? Faxed ❑
Notes: Mailed ❑
To be picked up 11