HomeMy WebLinkAboutRecords Request - OTH Record Requests - 8/29/2014 MASON COUNTY PUBLIC RECORDS REQUEST FORM
426 W. Cedar Street, PO Box 186, Shelton WA 98584
PHONE (360) 427-9670 ext. 352 FAX (360) 427-7798
Requestors name: Date: 1 !
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Company epresenting: Mail Fax Pickup View
Address: Phone:
City, State, Zip: Fax:
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Parcel #: `)1 �'l� iJu Parcel Address: U
Owner: Previous owner:
Please provide records for the Following:
Environmental Health Planning Dept. Building Dept. �(
Please specifically describe what records you are reques#ng.,
2914 --
AR ST.
***Please allow 5 business days for a response to your request. RCW 42.56.520 ***
agree to pay all copy charges pursuant to Mason County's fee schedule. RCW 42.56-120
certify the information obtained through this request will not be used for commercial purposes.RCW 42.56-070(9)
Requestors Si natur Date: o ! a Q I
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Official Use Only
Five-day notice sent Date:
Completion date
Completed by Ext.:
ee's due $
Records were Mailed Faxed Viewed Picked up
Notes