A-9- <br />City Recorder <br />125 E. 8th Ave., 2nd Floor <br />Eugene, OR 97401-2793 <br />541.682.5010 o 541-682.5414 Fax <br />www.eugene-or.gov <br />PUBLIC RECORDS REQUEST FORM <br />Name: <br />Bill Kloos <br />Date Requested: <br />Address: VV • 4-~* ('N c ~kz q ~ 0)~ 6) ` 0 <br />514 ( - 3 4 ~ - q Sr, 3~~~~~ LAS u S <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? w 0 <br />If yes, name of employee contacted <br />RecordslDocuments Being Requested: <br />,k{ LL "eV 0 ill~ 0 (14 la_:_ <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 />f iiiEi'f ililf iifi'iliililii~itiiifitlfllt~iillfllliiililitl~i~llii~~t('~f`I'tfi{IiifiiiitYlitl~ili~f~~l~•If~frili~'i'f'fi➢'{•I~i~~tiillliil)rtit~if iiliillit~'f'if Illllili~iti~ii'rCtii~iiiiilittl <br />litiifliiioliriiifl~'i3i111ii11 <br />For Staff Use <br />Information provided via <br />❑ Telephone <br />❑ E-mail <br />❑ Letter <br />REQUEST COMPLETED by on <br />ozta- 2,0 k,7 ~oq <br />Laurel Ridge Record (Z 15-5) Page 1063 <br />