Fillable ISLAND COUNTY PUBLIC WORKS (Island County Government)

Fill Online, Printable, Fillable, Blank ISLAND COUNTY PUBLIC WORKS (Island County Government) Form

Use Fill to complete blank online ISLAND COUNTY GOVERNMENT (WA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

ISLAND COUNTY PUBLIC WORKS (Island County Government)

On average this form takes 4 minutes to complete

The ISLAND COUNTY PUBLIC WORKS (Island County Government) form is 2 pages long and contains:

  • 0 signatures
  • 7 check-boxes
  • 11 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Island County Government

BROWSE ISLAND COUNTY GOVERNMENT (WA) FORMS
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
ISLAND COUNTY PUBLIC WORKS
REQUEST FOR PUBLIC RECORDS
Public Records Contact:
Alternate:
Office Hours:
Cecilia A. Herrera, Records Officer
Island County Public Works
1 NE Sixth St.
PO Box 5000
Coupeville WA 98239
Email: c.herrera@islandcountywa.gov
Anne Nysether, Senior Office Specialist
Email: a.nysether@islandcountywa.gov
8:00 am to 4:30 PM Monday-Friday Closed
on Saturdays, Sundays and Holidays
Island County government is organized into separate departments and offices of independently
elected officials. Each department within Island County is responsible for its own records. The
Island County Public Records disclosure contact Information, is located at
https://islandcountywa.gov/Pages/PRR.aspx. It offers a guide to help determine what
department and who to contact to submit your public records request.
Public records are available upon written request for inspection and disclosure. Requests for
inspection and disclosure of public records should identify the particular records desired with
enough specificity so it can be located.
Responses to requests will be provided within 5 business days. If additional time is necessary to
gather the appropriate records, the department Records’ Officer will inform you with the five
day time period, along with a date of when records can be expected.
Records that are part of a larger set may be made available on a partial or installment basis as
records are assembled or made ready.
Cost per printed page copied: $.15 per page single sided (no fee charged for
inspection of records)
Cost per page scanned and emailed: $.10 per page for records scanned into an
electronic format
ISLAND COUNTY PUBLIC WORKS
1 NE Sixth St., PO Box 5000, Coupeville WA 98239
REQUEST FOR PUBLIC RECORDS
Today’s Date: ______________________________________________________
Print Name: ______________________________________________________
Mailing Address: ______________________________________________________
________________________ ________ ____________
(City) (State) (ZIP)
Phone Number: ____________________ or Cell Number: _______________
Email Address: ______________________________________________________
Description of records seeking (include date, as best known) ___________________________
______________________________________________________________________________
_________________
__________________________________________________
___________________________________________________________________
___________________________________________________________________
Upon Locating documents I request: ______ Inspection Only _____ Inspection, then copy
(no fee) selected pages
_____ Printed records only _____ Copy ($.15 per printed Page)
_____ Electronic records only _____ $.10 per page/records scanned into electronic format
_____ Print and electronic records
Signature: ____________________________________________________
Printed Name: ________________________________________________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

ISLAND COUNTY PUBLIC WORKS (Island County Government)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 6 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document