099
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
L/d7/~ C5
+99
2009..:] 0-] 6 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTmG 0
CODE ENFORCEMENT 0
PLANNmG ~
ZONING 8
FIRE mSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept t /~_. ~.' .
Department Head approval:
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: ~/ _
Closed by: ~
Date: :t J7 / ID
Notes:
,---
Amount Due: I Pages for a total of $
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arne. , '~ .",\1"" ') (Y) oJ _ _ 0 c ec ere 1 you are
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Address: \ (J <X-\'\'\ ~\ \R. \) \ \., \ ..",~<.~'\>:)~~')~J'SG requestmg that the records
be mailed to this address.
Agency or firm:
Telephone #: ('l.Li I) ) ~- \ 1 ?~7 FAX #: (
Email address:
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SPECIFIC DESCRIPTION OF RECORD:
\'\:- ( r:;<"~__;~\:t-.. \ '0 \- 'r-.. \y..),- ',- \-- r- U f"\ y,,-,,:, '~~~, '-:J" ,\ ~ ') \----o~ 2:>
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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