Laserfiche WebLink
} Stockton <br /> CITY OF CITY OF STOCKTON <br /> INFORMATION / COPIES / RESEARCH REQUEST III I <br /> STOCKTON Notice: Requests for information may be subject to approval by the City Attorney <br /> NAME: (!r —(-f �aG(c�,s DATE: 40M, ,�L�, <br /> ORGANIZATION: j�,, , J� �_ , f [ ; fiTELEPHONE: UaADDRESS:�� �f- C—C J�6� A��e <br /> --4 <br /> I, the undersigned, agree to pay for research and all copies made at my request at the rate listed fortht service <br /> in the City of Stockton Fee Schedule at the time of my request. I _ <br /> SIGNATURE <br /> AFFECTED ADDRESS (IF ANY): �� �w; �, `rte �9 F- /`�A cj-� �✓-fa,I���.� <br /> INFORMATION REQUESTED (PLEASE BE SPECIFIC): Sze S <br /> REASON FOR REQUEST: <br /> - U <br /> FOR THE USE OF CITY ATTORNEY'S OFFICE.ONLY G���a <br /> REQUEST FOR RELEASE OF INFORMATION IS: APPROVE1 DENIED <br /> DATE �SNATURE OF CITY ATTORNEY OR AUTHORIZED REPRESENTATIVE <br /> COMMENTS: <br /> FOR CITY USE ONLY <br /> RECEIVED BY: DATE RECEIVED: <br /> I <br /> RETURN THIS REQUEST FORM TO: AAAEMAK--, y� LcC� }( 4 <br /> NAME DEPARTMENT PHONE <br /> RESPONSE TO REQUEST: <br /> SERVICE FEE x QUANTITY = CHARGES FEES DUE: YES NO <br /> Copies First page $1.00 <br /> Additional pages $0.25 per page <br /> Documents Notes: <br /> Certifications <br /> Media <br /> Research Time $8.10 per 15 min. <br /> COMPLETED BY: 11ir 15 min.) TOTAL DUE _ $ <br /> DATE: t , <br /> ddimas 6/22/05 <br />