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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton ~
.sue Rose 0
Date Received: 0:5 lOa.. j C)Q/O
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FOIL Ser, #: 33
DEPARTMENT:
ASSESSOR [
ACCOUN
CODE ENFORCEMENT 'g.
PL~~G 0
ZO~G 0
FIRE INSPECTOR 0
mGHWA y 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK. ~
WATER/SEWER C
DOG CONTROL OFFICER C
TOWN ENGINEER C
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
Date Received by Dept
Department Head approval:
Amount Due:
Name:
Address:
.:/J check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: 13ft.
Email address: .
FORMAT OF RECORD (if available)
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,f.
I request to be notified when I can come to inspect the record(s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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Washlngtonville Middle School Health Office
3S west Main St.
Woshingtonville. NY 10992
Phone: (845) 497-4000, ext. 21531
Fax: (845) 497-4037
pbookstein@Ws.k12.ny.us
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