HomeMy WebLinkAboutOTH Record Requests - 7/4/2014 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 ame: Date:
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Compa y Representing: Mail GG __Fax Pickup View
Address: Phone:
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City, State, Zip: Fax:
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Parcel #: Parcel Address: s�laaaq -56 -09,o3
Owner: Previous owner:
Please provide records for the Following:
Environmental Health Planning Dept. Building Dept.
Please specifically describe what records you are requesting.
***Please allow 5 business days fora response to your request. RCW 42.56.520 ***
I 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 Signature: Date:
Official Use Only
Five-day notice sent Date:
Completion date
Completed by Ext.:
ee's due $
Records were Mailed Faxed viewed Picked up
Notes