001
TOWN OF WAPPINGER
20 MIDDLEBUSH RD.
WAPPlNGERS FALLS, NY 12590
TOWN CLERK
OFFICE: 845-297-577] -FAX: 845-298-1478
APPLICATION FOR PUBLIC ACCESS TO RECORDS
Date Request Received: J - ~ .. } () FOIL # /
Recorded: Chris Masterson, Town Clerk
From:
Print Name: Lti1f1 /VltAc k.~j.jJ(~
Agency or Firm: {
Address: I .-\VIal1 'c....:d f11 ~ <' e ~" f I ""j s..,-{'d{ "/).5:"'q'o
Tel. #: $'i.,. c; (.. S'" ( _ t) "llf<:( , Fax #:
I hereby apply to: inspect the following record and/or
receive a copy @.25 c~ts Ipage if available to the public "
Descripti~n o~ record requested: l v Af (>'C lit r (I T
I\) l\ k"\1- ~. ~/ll,,~".,V'f- I ~"-"'l.
, lc)..l('" 1 0
i
('.' .r.J" S . /1
5 r ( ~y
("1 2 S
,J r0
~ c1 '
APPROVED/DENIED
REVIEWED BY:
i)tclA .~~
RECEIVED . ~ ~ c:x/~ J
DATE RECEIVED: 1- </_,ZrJ/tJ
Open 0 In Review 0 Closed 'ferried 0
APPOINTMENT SET: ~ 4- J u / 0
Department ~d
DATE FILED:
~