003
TOWN OF WAPPINGER
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20 MIDDLEBUSH RD.
WAPPlNGERS FALLS, NY 12590
TOWN CLERK
OFFICE: 845-297-5771 -FAX: 845-298-1478
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APPLICATION FOR PUBLIC ACCESS TO RECORDS
Date Request Received: /-/5-/0 FOIL # #3
Recorded: Chris Masterson, Town ClerIc
From: l Q.,>>' e
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Print Name: S h\'(l~ -'
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Agency or Firm:
Address: ,).l T(u.ffl-t tltr- eor~ GJ j-.
Tel. #: bSl -3S L""2- Fax#:
I hereby apply to: inspect the follO'wing record and/or
receive a copy @ .25 cents /page if available to the public .
Description of record requested: h ~~ '^ !d: o-Q .ukl-e cltU)
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APPROVED/DENIED RECEIVED BY: .
REVIEWED BY: DATE RECEIVED:
Open o In Review bfClosed D Denied D
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'0' ...) APPOINTh1ENT SET:
Department Head III ~ I dO/()
DATE FILED:
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