Aroaho <br />City Recorder <br />125 5 E. 8th Ave., 2nd Floor <br />Eugene, OR 97401-2793 <br />541-682-5010 9 541-682.5414 Fax <br />www.eugene-or.gov <br />PUBLIC RECORDS REQUEST FORM <br />Name: BIlI KlOOS <br />Date Requested: ` 7 <br />Address: VV. 4A /)N C ~ 60, Of- I_t/t I <br />5q 7 4--~ J -mail; _XLUa"% ~ L00-40U~ <br />Telephone/Fax: E <br />Will this information be used for commercial purposes? YES ❑ <br />Have you contacted any other City of Eugene employee about this request? W 0 <br />If yes, name of employee contacted <br />Records/Documents Being Requested: <br />A uc coo o (14 ~ t tj A- NA 2""o S 6 oq <br />Sam= <br />Please attach any additional background information that will help <br />City staff to locate the records requested. <br />See reverse side for important information about the City of Eugene's <br />. Public Records Request Policies and Procedures. <br />For Staff Use <br />Information provided via <br />❑ Telephone <br />❑ E-mail <br />❑ Letter <br />REQUEST COMPLETED by <br />on <br />Laurel Ridge Record (Z 15-5) Page 103 <br />