2024-316q
v Submiiting Rcqucst
1.0 0 'IQMVII (hir l'uhlic Rocortk Dalalmic 110,01
I Ic S uhm ktod i�l I �mj il Io 1111�,�L on"dm4l,ic 0 01,
__.. _� ___ _ "". 19CI"i Fall, Ql)
n , I I N T I f� a lmlii to 20 Midd](+wd-I Rd Wappi�
I appmgcrm �,'w� oi- in per�,oll
I OR IN I VRNAI�_1 St. om'-Y.
Rk:cctked urr. lowph P. Pit �lkln i
I. %IC(oll0I0Q[l
Orace Robinson
Dale Recck ed,
1011. Ser, r.,:
DEPAR I'MENT:
A SS L S S (") R
El
ACC(M:N I I\G
C0C )f. L N F R C I . X I I � N I
I 11(d MAY
RI C I : I VI 11 R F' 1, LS
El
RECREA VI ON
El
SLTERVI',�.,OR
VO WN C I , F R K
A I E R S L, R
F j
I
Ak N FIM i IN F LR
N A ITORNLY
TOWN (A" WAPPINCH'I
iC<fl i0l] I01' PUblic AcccSS to J�ccords
1"'OlL REVUEST
Date Receked b) Dept
[)epartt11elit I jcul apprcm at:
Date Applicant Ccmll�
1) ate FO I I filled r denied:
I 11 fi 011�11
ewClosed bw:
Date:
yq
Notes:
i\jljg)jIIj t Due: Pau%es tor a total OCS
F�clwck herr ifou are
NLIUCS6110 that (lie records
Address: _j. ..... . C�
Ire mailed to this addre"S.
. . ...... .. - -----
FAX 4:
hnad address:
I)l S(`RII1 I ION 0I" R FCORD'
)Q WL
T
L
F (g I�fj,(- f(f)
I_eLjllC'1t (0 he tl0IiI'1Cd %deil I Ctoljjk: III illSlICCt OIC l'CC0l'dl`11 &,,crihed tlhoa e
req ue!,t co 1) i Q I I ie reci � rd'. ri hed ah") 1 c 3d ld l u'ree tai IM I hQ cIst ,I f suc 11 reck wd S i11
aIcc (I I'djIlce rI, I I I, the lee c:IlecltoIe 4111 the lm�: k I' (it i pp I ic'l t I o 11
I requeNt that the I�L:CkWd, he "Cill ti i,,l C-111jil to III e Okjrc�s Ililted ahoNc
I NklilVIA thA. the FCCORF, he h,\Cd 10 [11C Mllyll)Cl liqcd ahmv