105
Received by:
Chris Masterson 0
Christine Fulton \.~
Sue Rose d
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~.
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGH1VAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
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Date Applicant Contacted: J / S- / /()
Date FOIL fulfill~'>; .:;-/ /U
Closed by: If 6-
Date Received by Dept
Department Head approval:
Date:
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Notes:
Name: \)\ to
Address: 2LllDl l' CJD
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Agencyorfinn: MMi1(1.- flL,'z lrJ'J1~lll1f)~
Telephone#: ('OY< ) '51.2 - '1611 FAX#: (
Email address:
Amount Due:
Pages for a total of $
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
~\'L(2,1S"(<Z.O )N ~'NI) CJL.r1' WttO IS '3t..'ltf)I-N(4 F4\ rao~<0~ '2-L\\./(,. ~I 1 D. )
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FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record( s) described above
o I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
o I request that the records be sent via e-mail to the address listed above
o I request that the records be faxed to the number listed above