COPY REQUEST FORMCOPY REQUEST FORM
(Mt. Shadow Subdivision)
Person Requesting: Nisha R. Box
Date Requested 3/2/07
Daytime Phone:360-458-8430
Deputy Requesting:
DOCUMENT TYPE / VOLUME / PAGE / AF NUMBER
TOTALS
4 Copies of full size plat map
1 11x17 copy of plat map
1 email copy of plat map nishab@ci.yelm.wa.us
Total Fees: $
Plotter:
Blueline:
8 ½ x 11:
11 x 17:
Certified:
Paid:
Due:
No Fee:
Bill:
Receipt Number:
Mail:
Pick-up:
Drop Box:
Fax:
Fax Number:
Mailing Address:P.O. Box 479, Yelm WA 98597
Ordered Mylar from _______________ at R.C. Date:___________ Time:___________ Deputy:___________
DATE
TIME
DEPUTY
ACTION TAKEN
Copies Completed By:(deputy’s initials)
Date:
Mailed By:(deputy’s initials)
Date:
Copies Picked Up By:(print name)
Date