104
Received by:
Chris Masterson 0
Christine Fulton 0 /
Sue Rose . Y"
1-1 111 ~ '-......
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
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o~ ~AP"'I
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0 ./
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN AITORNEY 0
Date:
FOR DEPARTMENT USE ONLY
Date Received by Dept 01-- I .11 I L2-
Department Head approval: 2IfL
(iiit)
Date Applicant Contacted: 1. I :< ~ I I?J
DateFo&rdenied: Lf !if e
Closed by: J.( q
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Pages for a total of $
(3
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Amount Due:
Notes:
Name: VI C. Q-e ~O
Address: :>") le4Sn-nr Ut~ h:?
?l..Q:t"rS.~ ~~~ 12S6?
Agency or firm: t6 ~ ~4-v\. ~ N1N\.C-O r2-<f~
Telephone #: (~51 !n.?I ct'?:v FAX #: @tr) ~- 9 7 '?~
Email address: r-Q... ,....~ ~ \-tC:::H.d l M NA-<-t:> re Yl eo <. ~ Yld
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCR!fT1E OF RECORD:
A-(t~.. {~ r~~~;:V'... [4 (J. ~cx.. ~'J W~A.(S.o~
~ "-'- l c\ t A; NY\. .0 /.) J {b t/Y}1 (b/C!
,
FORMAT OF RECORD (if available)
~ 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