HomeMy WebLinkAboutOTH Record Requests - 10/19/2010 *.0s CooNTF MASON COUNTY Date Stamp
Department of Community Development
PO Box 186
426 W. Cedar Street
Shelton, WA 98584
Phone: (360)427-9670 ext. 352
Fax: (360)427-7798 Received by:
PUBLIC RECORDS REQUEST FORM
Phone
Namen�4
Faxz Address I 1Er�aalCity, State,
CC Cull
Parcel No.q
Parcel Address
ZL� - _----- -
Owner �� f�' ,I-�G Previous Owner
Gd Buildin Department Records aPlanning Department Records
Type of Records: 9
Record(s) requested: Please describe a specifijiidetifiabl�erecord. Include document name, number or date if known.
a)oq -car v�i
cs L� - 1 C ) r _�
5
zl I �
❑ I would like to inspect the record(s)at no charge
I would like a copy of the record(s): ❑ Mailed Faxed W Emailed (if available in electronic fo at) icked up
Please allow 5 business days for a response to your request. RCW 42.56.520
1 agree to pay all copy es pursuant to Mason County's fee schedule. RCW 42.56.120
I certify the informatiornobtai ed through this re est�will not be used for commercial purpose . RCW 42.56.070(9)
Date
Requestor Signature
OFFICIAL USE ONLY
FLI 5-Day response Date: __
\Search Criteria Used ❑Perm7Dept.
❑ Scanned Records 19.parcel Files
❑ Email Search ❑ Plan❑ Tidemark Files ❑ Plan Vault ❑ Coun❑ Meeting Notes /Date:
l
Request Closed -By:
c� Fees Due$
Records were b� ailed Faxed ❑ Emailed ❑ Picked up
Notes
Make checks payable to the Mason County Treasurer