8935 Crystal Springs Rd Davis CA,
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RECEIVED
CITY OF YELM MAR o s FICIAL USE ONLY
PO Box 479 Date ReceNed
Yelm WA 9859j5C- \VE4er .. •• .av
(360) 458- 3244'
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CITIZEN ACT
NOTE: Information provided on this request form Is subject to public disclosure,
and is available to individuals upon request. If you wish to remain anonymous,
the City of Yelm reserves the right to not follow-up on the request.
NAME:
PHONE: ' F - °1oc -/0- ?/
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ADDRESS:
MAILING ADDRESS (if different than above):
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CITY OF YELM POLICY NO. 91 -01
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