HomeMy WebLinkAboutOTH Record Requests - 9/28/2009 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 name: Date: G,.
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Company Representing: Mail Fax Picku View
Address: vu Phone:
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City, State, Zip: Fax:
Parcel #: _ Parcel Address:
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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 for a 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
I 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