HomeMy WebLinkAboutOTH Record Requests - 8/10/2007 MASON COUNTY PUBLIC RECORDS REQUEST FORM
426 W Cedar St, PO BOX 186, Shelton WA 98584
PHONE (360) 427-9670 FAX(360) 427-7798
Please allow 5 business days for us to respond to your reauest*
'if items are being mailed please allow an additional 3 days until you receive the paperwork
I would like the information: Requestor's Name IkI , ,�' L 4�^
Mailed ❑ Faxed ❑ Picked Up ❑ Address c{ 0 26
Date of Request 0 Lo City ,. St W � Zip o �/
Time of Request Phone 75_3 433- 370'S Fax
PLEASE PROVIDE RECORDS FOR THE FOLLOWING:
Septic Records ❑ As-Built Only ❑ 12 Digit Tax Parcel No.
Other (See Below) ❑ a Z t 3- a - -3 L _ C) 0 _
Present Owner oT t,4 bx.c�"J Legal Description
Previous Owner ` k i�,,t: E Site Address ,� 1`-30 uJ64 ?A—AA e
Please specifically describe what records or kinds of records you are requesting: 4.44
� i 2.a-J S 1 �� -�-, �� ��L Gti11 Sc� - I✓l ty
• RCW 42.56. I certify that the information obtained through this request will not be used for commercial
purposes.
Signature Date D 0
• Large requests may be charged as provided by RCW 42.56. During file re 'ew, any pages you with to
have copied (excluding non-public record documents)must be tagged and charges will be assessed at
.15 cents per page. Copies can be mailed 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
per page
Official Use Only
Request Routed To: PAC File Clerk ❑ County Admin. ❑ Clerk of the Comm. ❑
Other ❑ Building ❑ Planning ❑ Environmental Health ❑
Public Works ❑ Assessor ❑ Auditor ❑ Treasurer ❑
Completed by: Ext Records were
Completed date: Faxed ❑
Notes: Mailed ❑
To be picked up ❑