PUBLIC RECORDS REQUEST FORM <br />Name: Bill Kloos <br />Date Requested: <br />Address: ~ V/V - <br />Telephone/Fax: E-mail: <br />Will this information be used for commercial purposes? YES ❑ <br />Have you contacted any other City of Eugene employee about this request? 1 v 0 <br />If yes, name of employee contacted <br />Records/Documents Being Requested: <br />,~A U C_ Lo (14 0 A- 2"v <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 />~~~tiYi~~~~~i~~YY~~~~~~~i~~~~~~~~i~~~~~i~~~~~~~~i~~i'~~iY~1V~~~1~~i~~~i~Yfi~~~~~~~~V~~~Y~~~~Y~i~i'~~i~'f~GW69i~i~i~i~~`r1~i~~i~~i~3~~'~~ii~~Y~i~i~i~i~i3i~~~~t~~~~ii~~S~➢~~~~~~ii~i~~SW~~~~h~~~~1G~~4i~ <br />Giiiv~W~~hia~'6~tiY <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 1251 <br />