HomeMy WebLinkAboutOTH Record Requests 4 W V�-- ... . .4 yw•dw 9x"%AvMU0 KMAUC.Yrr FORM
Cedar St,PO BOX 186,Shelton 161A 98584"
PHONE(360)427-9670 FAX(360)427-7798
Please allow 5 business days fo us to rg and to your roquest* ��c. w T�-t-!
'fr are being ma ed pime allow an a"bonal 3 days until you n wtm the papwwodc .
would like-the information: Requestoes Narne
Mailed ❑ Faxed ❑ Picked Up ❑ Address w
Date of Request City St
Zip
Time of Request. &_o #-
Phone .611;2-yl yl Fax
PLEASE PROVIDE RECORDS FOR THE FOLLOWING:
Septic Records ❑ As-Built Only ❑ 12 Digit Tax Parcel No.
Other(See Below) ❑ / _ �_� C) l "
Present Owner Legal Description
Previous Owner
Site Address _
Please specifically describe what records,or kinds of records you are requesting:
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-RCW 42.17.020 I certify that the information obtained
through'commeraalprposes.: u rough this request will not be used for
. . .
Signature Date
Large requests may be charged as provided by RCW 42.17.310. During file review, any pages
You wish to have copied (excluding non-public tecord documents) must be tagged and charges
Will be assessed at .15 per page. Copies can be maped'or you may pick them up when ready.
• Copies of blue prints or other large format items, when available, may be charged a higher rate
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'Official Use Only
Request Routed To: PAC FQe Cletk ❑ County Admin. ❑ Clerk of the Comm.
Other ❑
Public Works ❑ Assillding . Planning ❑ Environmental Health ❑
Auditor Treasurer
Completed"by: Ext — Records were
Completed date:ate:
. Faxed ❑
Notes: _ Mailed ❑
To be picked up ❑