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2. 

3. City of Yachats

   501 Highway 101 N

   PO Box 345

   Yachats, OR 97498

4. Contact Us

   Phone: 541-547-3565

   Fax: 541-547-3063

8. First Name*
9. Last Name*
11. Address 1*
13. Address 2
15. City*

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16. State*
17. Zip*
19. Phone Number
20. Email Address*
24. Records/Information Requested:*

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26. Department

    1. Police
    2. Building
    3. Public Works
    4. Clerk

    1. Community Development
    2. Administration
    3. Finance
    4. Other
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35. Electronic Signature*
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