HomeMy WebLinkAboutOTH Record Requests - 4/26/2010 � .
°p°ter MASON COUNTY Date Stamp
A Department of Community Development
PO Box 186
426 W. Cedar Street
Shelton, WA 98584
1854 Phone: (360)427-9670 ext. 352
Fax: (360)427-7798
Received by:
PUBLIC RECORDS REQUEST FORM
Name WOC� Phone
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Address �� O Fax . �a-
City, State,Zip - Email
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Parcel No./ c� - �- ��t Parcel Address
Owner &W �/1(x �J`J�j.� Previous Owner
Type of Records: ❑ Building Department Records ❑ Planning Department Records
Record(s) requested: Please describe a specific identifiable record. Include document name, number or date if known.
❑ I 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 obtained through this request will not be used for commercial purposes. RCW 42.56.070(9)
Requestor Signature Date
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OFFICIAL USE ONLY
❑ 5-Day response Date: 1.
Search Criteria Used
❑ Scanned Records ❑ Parcel Files ❑Permit Center
❑ Tidemark Files ❑ Email Search ❑ Planning Dept.
❑ Meeting Notes ❑ Plan Vault ❑ County Archives
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Request Closed - By: f `r Date: }
Records were: ❑ Mailed ❑ Faxed ❑ Emailed ❑ Picked up Fees Due $
Notes lam- -- `. c r'`T )i t c t f t-_ Ei t C
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Make checks payable to the Mason County Treasurer