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138 Received by: Chris Masterson 0 Christine Fulton \i Sue Ro~. 0 0 OIIQ::1 / ~ ) 30 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST , . . RECEIVED . . ,~ JUL 092 ~ DID ~OF~~NT 'NGEft FOR INTERNAL USE ONLY Date Received: FOIL Ser. #: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT .~ PLANNING .~ ZONING ~ FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK 0 WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept :z / .!L / /0 Department Head approval: ~ (init) Date Applicant Contacted: -1/ /1/ L.!!. DateF~enied: _1_1_ Closed by: Date: ~. j LI& 10 Notes: Cl~( Pages for a total of $ Amount Due: Name: Address: o check here if you are requesting that the records be mailed to this address. )-- r ~ hA I V\. +~ re s~ i Vl ~k i ') tL --r--BI ~. Pe.r-ww.t:r FORMAT OF RECORD (if available) I request to be notified when I can come to inspect the record(s) described above o 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