01302024-2200 S. Anaheim Blvd., Suite 217
Anaheim, CA 92805
714) 765-5166 • fax (714) 765-4105
www.anaheim.net
Request for Public Records
Page 1 of1CityofAnaheim
Office of the City Clerk
STEP 1:COMPLETE all fields on this form. This form is to facilitate and expedite the processing of your public records request.
Describe identifiable records in the possession of the City; your request must be sufficiently focused and specific to
allow the City to locate the requested record(s).
STEP 2:SUBMIT completed form by mail, fax, email or in person to Custodian of Records, Office of the City Clerk,
200 S. Anaheim Blvd., Suite217, Anaheim, CA 92805; tbass@anaheim.net fax: (714) 765-4105
STEP 3:WAIT to receive a response from the City. The City shall determine within 10-days from receipt of a public records
request, whether the request, in whole or in part, seeks copies of discloseable public records in possession of the City
GC 7927.535(a)]. Please note that if you are requesting the opportunity to inspect records, you will be requested to
make an appointment to return at a later date/time to view the documents.
Charges for the direct cost of duplication will apply . Documents will not be copied until payment has been received. If
payment is not received within 20 days after invoice is sent, you may be required to submit a new request. Please see
backside for additional information.
REQUESTER INFORMATION
Full Name:Date:
Company Name:
Mailing) Address: City/State/Zip Code:
Phone number: Email:
Preferred method of contact in the event of questions:
Jack Mirassou 1/30/24 10:40 AM
N/A
92627
com949-
email
DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering documents requested etc)
Requesting a copy of all public and ongoing code violations cases that have to do with uncut grass, structural damage, and mold that have
received a courtesy notice or been fined within the past 60 days. This request pertains to all residential addresses within the records of the
department. Request includes but is not limited to the case number, property address, and the violation type that took place.
I understand that I will be contacted once documents have been identified. If production of records is requested, an estimated cost will be
provided to me and I agree that I will be required to submit payment for duplication costs (and mailing) prior to the production of the
requested documents.
Please note that information contained in any PRA request is a public record and may be subject to public inspection pursuant to the
California Public Records Act.
I wish to inspect City records X Will Pick-Up Records
Electronically Signed/Submitted 1/30/24 10:40 AM
SIGNATURE OF REQUESTER
Please Mail