HomeMy WebLinkAboutOTH Record Requests - 7/14/2010 MASON COUNTY Date Stamp
Department of Community Development
PO Box 186
° 426 W. Cedar Street
f 1 Shelton, WA 98584
jxS4 Phone: (360)427-9670 ext. 352
Fax: (360)427-7798
Received by:
PUBLIC RECORDS REQUEST FORM
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Address Fax
City, State,Zip Email
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Type of Records: WBuilding Department Records ❑ Planning Department Records
Record(s) requested: Please describe a specific identifiable record. Include document name, number or date if known.
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❑ I would like to inspect the record(s) at no charge
I would like a copy of the record(s):I�/Mailed ❑ Faxed ❑ Emailed (if available in electronic format) ❑Picked up
Please allow 5 business days for a respon to your request. RCW 42.56.520
I agree to pay all copy charges pursuant�o Mason County's fee schedule. RCW 42.56.120
1 certify the information obt ' rough is request will not be used for commercial purposes. RCW 42.56.070(9)
Requestor Signatu e _ Date
❑ 5-Day response Date:
Search Criteria Used -
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Records were: d Mailed ❑ Faxed LT mailed ❑ Picked up Fees Due $
Make checks payable to the Mason County Treasurer