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2. Please note this form is NOT for As-Built or Availability requests. Please use the As-Built or Water and Sewer Availability request form from the menu at the top of the page under "How Do I" and choose "As-Built Request" or "Water and Sewer Availability".
4. First Name*
5. Last Name*
7. Address 1*
9. Address 2
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Email Address*
18. Records Requested*
    Describe the public records you wish to receive. In order to expedite the search for the records, please be as specific as possible.
20. Media Format*

    1. Electronic Copy
    2. Hard Copy
22. I wish to have hard copies of the records indicated above. I understand that there will be a charge for hard copy duplication of the requested records. A minimum of $0.15 per page for standard size copies will be charged to the requester. The requester may be required to provide a deposit in the amount of 10% of the estimated cost of providing copies of the records. If the District provides copies of records on a partial or installment basis, the requester shall pay the copy charge for each installment as it is provided to the requester.*

    1. Yes

    1. No
24. I wish to make an appointment to review the records indicated above before copies are made.*

    1. Yes

    1. No
26. RCW 42.56.070(9) prohibits the disclosure of lists of individuals for commercial purposes. If requesting lists of individuals, please affirm the following statement by checking the box with this sentence: I certify I will not use any requested lists for commercial purposes.*

    1. Yes

    1. No
28. Signature of person making the request*
    The District will respond to this request withing five (5) working days.
30. Electronic Signature
32. Date of Request*
    Date of Request
34. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your request will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field