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TOV1'N OF "", APPINGER
20 MlDDLEBUSH RD.
W APPLNGERS FALLS, NY 12590
TOWN CLERK
OFPICE: 845-297-577] -FAX: 845-298-l478
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APPLICA110N FOR PUBLIC ACCESS TO RECORDS
Date Request Received: :3 j I J ) I ()( ~ ~ ') FOIL # L/ i
Recorded: Chris Masterson, Town C~rk
From:
Print Name: . Br'~n R(t.n"\L~
Agency or Finn: ~...s n{~~ 1:.,.
Address: ~,y b \ ,.!I( 't!u ~"p~Il~' J tift I J 66:3
Tel. #; C6.19l{S~~ "Sf Fax #:.JJ:Jl1 '-!~~"':1QP
APPROVED/DENIBD
REVIEWED BY:
tifl.J~ c/ ~r'
~) tI()t2~~
Department Head
I hereby apply to: X inspect the following record and/or
receive a COpY @ .25 cents /page if ava.ilable to the public
Description of record requested:__.B.dL,Li\~ ~(fM'~ ((c'vrJr tnfU~
-p(!'\-m\C\.N'l'\ ~~/'l.1\ r~"'JV\ (~ p~~ c 0:.. ~ R.lf. .r~,. -+w ~t><"'h~ I~" kJ
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RECETVED BY: 1/. c;t/aA-
DATERECENED: 3-(1-/0
Open~In Review 0 Closed 0 Denied 0
APPblNTMENT SET:
DATE FILED:
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