HomeMy WebLinkAboutOTH Record Requests - 12/19/2012 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
Name
Phone 76 C
Address Fax
City, State, Zip s k1A 4 g 2 Email
/ c�in Ps- P SSA r i.�►�• C �,
Parcel No. / 2 3 Z ( - Z -Q�.�! L9 O Parcel Address
Owner I//• nl d Previous Owner
Type of Records: ❑ Building Department Records YPlanning Department Records
Record(s) requested: Please describe a specific identifiable record. Include document name, number or date if known.
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J-1 would like to inspect the record(s)at no charge
I would like a copy of the record(s): ❑ Mailed ❑ Faxed ❑ Emailed (if available in electronic format) ❑Picked up
Please allow 5 business days for a response to your request. RCW 42.56.520
1 agree to pay all copy charges pursuant to Mason County's fee schedule. RCW 42.56.120
1 certify the information obt ' rough request will not be used for commercial purposes. RCW 42.56.070(9)
Requestor Signature Date /I /1 / 14
OFFICIAL USE ONLY
❑ 5-pay response Date:
t- :z,�•,r r e t�r` t c R = e r-��a t a t r c �dr�ras- �► a�a�ar`r` �r ,
- . -Search_Criteria Used
Scanned Records = ❑Parcel Files El Permit Center -
❑Tidemark Files- ❑Email Search = ❑ Planning Dept
LI Meeting Notes - - ❑ Plan Vault ❑ County Archives
Request Closed -By: Date:
Records were: ❑Mailed. ❑ Faxed_ ❑ Emailed _Picked up Fees Due
Notes_
Make checks payable to the Mason County Treasurer