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183
Au~ 19 10 12:45p Micke~ A. Steiman
.'\VVI , II ~U1 UI J. vu U.J. I.) I\,U
845-229-6338
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FOIL Ser. #:
Chris Masterson 0
Christine FultoD 0
Sue Rose -g/
XI ill 10 a
J<{ b
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
fOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT .a
PLANNING 0
ZONING 0
FIRE INSPECTOR. 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
0'" W,A}>F>/-\:
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('S5 co\)
Date Rccei"ed:
FOR DEPARTMENT USE ONLY
Date Received by Dept /.Il I rQ I!.D..-
Department Head approval:
Date Applicant Contacted:
(init)
I I
Date FOIL fulfilled or denied:
I I
--~
Closed by:
Dare: I I
No...: - 7-13)
I
; .
Amount Due: _ Pages for a to~'OfS~
Nmn.:~S 'r:Sl
Ad&eso: q. I< ~1s~00.& .
Agency or 6nn: Lo.(,J.) ~~c..es III ~ ~~ ~ So-'^-S
Telephone #: ('24~ ~- ~~In\ FAX #: (")4s) 'Zl.'9 - <os~~
Email address:
o chock here if you are
requesting that the records
be mailed to this addr~6.
SPECIFIC DESCRIPTION OF RECORD:
Any correspondence, notes, memoranda, documents and materials submitted by
or concerning the Foundation for the Chapel of Sacred Mirrors and/or Alex Grey.
FORMAT OF RECORD (if available)
J mqucst to be notified when I can come to inspect the record(s) described above
o I request copies of the records described IIbove and agree to pay the cost of such records in
accordance with the fee sdlcdule on the bade of this application
o I request that. the records be scot via c-mai11o the ad<hc&8 listed above
o I request that the m;ords be faxed to the number listed above:
