HomeMy WebLinkAboutOTH Record Requests - 7/24/2007 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
Mailed ❑ Faxed ❑ Picked Up,/�, Address
Date of Request I City St Zip
Time of Request Phone Fax
PLEASE PROVIDE RECORDS FOR THE FOLLOWING:
Septic Records ❑ As-Built Only ❑ 12 Digit Tax Parcel No.
Other (See Below) ❑
Present Owner Legal Description
Previous Owner
Site Address
Please specifically describe what rec rds or kind of records you are requesting:
r
• RCW 42.56. I certify that the information obtained through this request will not be used for commercial
purposes.
Signature Date
a i
e Large requests may be charged as provided by RCW 42.56. During file review, 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 a e
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 ❑