HomeMy WebLinkAbout02-09-2004 - Supplemental MaterialsCITY OF MEDINA,
DECLARATION OF PO,>TING
does declare as fcllows:
That he/she is a Public Works employee of the City of Medina and that on the
day of 20 ; , he/she caused a true and correct
legible copy of the following described documents to be posted at each of the following
indicated locations. -
Public Notice Board at the Medina Park - NE 12t" Street Parking Lot
Medina City Hall, 501 Evergreen Point Road, Medina, Washington (a
designated official posting place of the City of Medina);
The Medina Post Office, 816 Evergreen Point Road, Medina, Washington (a
designated official posting place of the City of Medina);
At two locations within 300 feet of the property in question described by its
street address as:
Description of document: -----------------
a'
A copy of the posted item is attached hereto.
Signed under the penalties of perjury,of the Laws of the State dina,
te of Washington at Me
Washington this day of
20
Signature ----of posting Employee
Delivery Deadline Document Type
CITY OF MEDINA
501 Evergreen Poin! Road/P.O. Box 144
Medina, WA 98039-0144
425.454.9222/Police 454.1332
DOCUMENT DISTRIBUTION RECORD
FOR
COUNCIUBOARDS/COMMISSIONS
Date: Officer:
Serial #:
City Council Date
-, ;
Time
Planning Commission Date Time
Adam i v
"`
Lostrom —
Blazey
f A'
Brog
Nunn f'
Nelson
Odermat i
Greenspoon
Phelps
Jordan
-Z
Rudolph /
') `'
%,1 {, : ,;" „
Lawrence
Vall i S nosa
p
Price
Park Board Date
Time
Civil Service Commission Date Time
Brazen
Dern-Palmer
Gerlitz
Holman
Hill
Jorgensen
Nunn
OTHER
Clyde Hill Town of Hjnts Point
Please return completed form to City Clerk's Office. Thank you.
p:\forms\council document delivery.doc
DATE: ee- ,�� �—j _ r �,
BEFORE:
PUBLIC HEARING SPEAKERS
PLEASE PRINT YOUR NAME AND ADDRESS
FOR THE RECORD
PLEASE PRINT YOUR NAME AND MAILING/STREET ADDRESS
NAME ADDRESS ORGANIZATION
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