HomeMy WebLinkAboutRecords Request - OTH Record Requests - 10/17/2007 # �,�, Mason County Public Records Request Form
�a�- 426 W. Cedar Street, PO Box 186, Shelton WA. 98584
*C Phone: (360) 427-9670 X-352 Fax: (360) 427-7798
>�tib I would like information: Mailed_Faxed Picked Up)(Date: —I
Requesters Name:
Company Representing:
Address: p &I Email:
City: ('4a" State:Wyq Zip: Q Z
Phone: A-b `ZO Fax:
Parcel No.
Parcel Address: .2, n S-{ ����0✓�
Owner: S/�Cq e_ ki& Previous Owner
Please Provide Records For The Following:
Environmental Health Planning Dept. Building Dept.
kind Please specifically describe what records or of r ords you are requesting:
RCW 42.56 I certify that the information obtained this request will not be used for
commercial purposes. Signature Required:
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 cony. Larger than 8.5"x 11"will be charged at a higher rate
e
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
Completed By: _13an r-,z Ext. 7 Q_-� 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.