04252024-2City of Anaheim
Office of the City Clerk
200 S. Anaheim Blvd., Suite 217
Anaheim, CA 92805
714) 765-5166 • fax (714) 765-4105
www.anaheim.net
Page 1 of 1
Request for Public Records
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: Marguerite Kisslring
Company Name: Lightbox / PZR
Date: 4/25/24 9:19 AM
Mailing) Address:
Phone number:
Preferred method of contact in the event of questions:
email
City/State/Zip Code: Oklahoma City OK 73108
Email:
DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering documents requested etc)
5635 E La Palma Avenue, 5621 E La Palma Avenue, 5631 E La Palma Avenue
Please provide copies of any variances, special and conditional use permits, and exceptions for the referenced property.
If fees exceed $25.00 please contact.
Ref# 172236-1
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.
I wish to inspect City records Will Pick -Up Records X Please Mail
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.
Electronically Signed/Submitted 4/25/24 9:19 AM
SIGNATURE OF REQUESTER