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013 Date Received: Chris Masterson 0 Christine Fulton ,~ Sue Rose 6 -L/cijl J0- J? 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Received by: DEPARTMENT: ~ "- ASSESSOR ACCOUNTING 0 CODE ENFORCEMENT 0 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 ATTORNEY 0 o~ ~Ap'''1. $~- : -- ;"~'''''' '- _"OiA ''-~~'' ,t- :1 ' · \ Cl\~'~~.) .c:. _~~.--'~ - /z: ~ _ _' J,..I -- (I..L ,,' ~.' ''''~i;5-c:o~~ ' FOIL Ser. #: FOR DEPARTMENT USE ONLY Date Received by Dept / I' ~ -1 {) Department Head approval: .e (init) Date Applicant Contacted: / / Date FOIL fulfilled or denied: _ 1 .,..4- 1 _ ;;/ dt /L/fL / ~f" / 1'27/ / () --- Closed by: t Date: Notes: Amount Due: Pages for a total of $ Name: Address: '~') j'i: ~~u tL. ~ "") ~o cOd!.. ~"tp._Jt '1' fl t.E f'<:... \-t I<-~~L \~f~ :ru.~ OO'C",," k. '1 125' s> " , ~-- check here if you are requesting that the records be mailed to this address. Agency or finn: Telephone #: ~5'-) U 1 - 6' 'f( t FAX #: ( Email address: g ,,+ - l..('-\ '\ ,-GJ C'{ \ (ell-H) )-- FORMAT OF RECORD (if available) IB-- I request to be notified when I can come to inspect the record(s) described above [E. 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