Lacey, WA · Thurston County
Appeal of a Hearings Examiner’s Decision
This form lets an appellant give written notice to the Lacey City Council and identify alleged errors in a Hearings Examiner’s decision.
What this form is
An appellant uses this form to give the Lacey City Council written notice of an appeal of a Hearings Examiner’s decision. It asks for the appellant’s name, the decision date and subject, alleged errors, a signature, and contact information. The form includes fields for Community Development Department staff to record filing details, a fee receipt number, the council meeting date, and the decision.
Who needs it
A person appealing a Hearings Examiner’s decision to the Lacey City Council uses this form to state the alleged errors.
How to submit it
File the form with the Community Development Department; the document includes fields for the filing date and fee receipt number.
About notarization
This document is signed without a notary; the form asks the appellant to sign and provides no notarized or sworn attachment step.
How to submit this form
- 1
Download The Form
Download the Appeal of a Hearings Examiner’s Decision form.
- 2
Complete The Form
Enter appellant and decision details, explain the alleged errors, and sign the form.
- 3
Gather Attachments
Attach an additional sheet if more space is required to describe the alleged errors.
- 4
File With The Department
File the completed form with the Community Development Department.
Frequently asked questions
- What is the Appeal of a Hearings Examiner’s Decision form?
- It gives an appellant a way to notify the Lacey City Council in writing of an appeal and state alleged errors in a Hearings Examiner’s decision.
- Who uses this appeal form?
- An appellant seeking review of a Hearings Examiner’s decision by the Lacey City Council uses this form.
- Do I need a notary for the Appeal of a Hearings Examiner’s Decision?
- No. This document is signed without a notary; the form asks the appellant to sign and provides no notarized or sworn attachment step.
- How do I submit the appeal form?
- File it with the Community Development Department. The form has fields for filing details and a fee receipt number.
Need something notarized?
This Appeal of a Hearings Examiner’s Decision doesn’t need a notary — but if you have another Lacey form that does, a commissioned online notary can help.