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187 Au~ 19 10 12:46p Micke~ A. Steiman ^ u u r I 1/ L V I VI J U r. V.J, 1.J '\Ill - , "t 845-229-6338 ,'1\" !tv. V'LJ p.? I. VUL FOIL Ser. #: Chris Masterson 0 Christine Fulton 0 Sue Rose ''Vi'' LI 13,../'--L C5" _l~l 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST EOR INTERNAL USE ONLY Received by: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR ~ TOWN CLERK 0 W A TERlSEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATIORNEY 0 ~ 'l/A"p o ",- ,'", _t~,..:p~ o . ~ .... 0: ~.)- c::., tr-':.-_ ' ~ ....~4lIF -t- 'i~.., .,~ 5s CO'" f/02:04 Date Received: I~ EOR DE' ARTMENT USE ONLY Date R.eceived by Dept Department Head approval: , I (init) Date Applicant Contacted: _'_'_ Dale FOIL fulfiUed orM-' ~ Closed by: ~ Date: ~ / z~,1 () Notes: t-Jo reCbYc:l$ \~ ~... ~~e..e- Amount Due~ _ Pages for a total ofS Name:~ 'e-"l Address: 'I _ _ n ~)~+ . ~!!I ~ l~~~ . Agency or firm: Lo.~ ~~c...e.s C) ~ ~UAi ~ ~ Te1ephone##:(ca4~.zn- ~~~ FAX#: ('"Jr4S)'Zt9 -<.os<..~ Email address: o check here if you are requesting that the records be mailed to this addr~6. SPECIFIC DESCRlPTION 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) I request to be notified when I can come to inspect the record(s) described above o I request topies of the records described above ao.d agree to pay the cost of such records in accordance with the fce schedule on the back of this application o 1 request that the records be smt via e-mail to the addrc&8 listed above o 1 request that the l"e(i()rds be faxed to the number listed above 0501236600 TRANSACTION REPORT AUG/23/2010/MON 01:20 PM P.01/0! . FAX(TX) E~==I~~TE _ISTART-T~HRECEIVER-----------------ICOM~IMEIpAGE11YPE/iOTE--------------------I----j ______ __________ FILE _~~~ ~~G/23 01:15PM 2296338 -------------- -O~OO~35 --1- MEMORY---oi------------------ ---- ---- -------- ------------------------- -------- ---- --------------------------~~~ ~~~~ Au~ 19 10 12~4Gp Hicke~ A. Steiman I\UU{ 1/1 t.UIUI 'v':' v.j. 1.J nl" EOR INTBRNAL USE ONI.. Y Received by: . Chris Ma&terson 0 Christine Foltbn if 0 Sue Rose L I .L:t 11.._9.- ~ bate Receive.d: rOn. Ser, #; DEPARTMENT: ASSESSOR 0 ACCOUNfINO 0 COD:E ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 0 RECENER OF TAXES 0 RECREATION 0 SUPERVISOR ~ TOWN CLERX 0 W A TBRlSEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATrORNEY 0 B45-229-6338 t^^ lOU, fJ't.J p.? I, VVL 2009.10-16 JCM TOWN OF WAPPINGER 'Application for Public AcCess to Records FOIL REQUEST ~~. ''''''~''~~~i; l ,". .'~",~. ....; '> o'~:~ c.~.....' ....~..... ".....r... .' ..::~ "'.55 cO' EQB. pEP!Jt.TMBN1' USE ONLY Date Received by Dept Department Head approvll1: I I (init) Date Applicant Cont~ted: _, ~ I _ DaIo FoiL fulfiU.d or M-1 ~ Closc:dby: ~ pate: ~I z~lll) Not('$~ N 0 r~$, \'I('\_~-r ~~c:.e~. _ Amount Due: --'- Pages for a total of'S N...: ~ 'l:."~ Q cheol;bere if you ... Address: q ~~-!-~o..~ -~ requesting that lhe records ~ .l2...~~~ . be :mail~ to this address. Agency OJ' fum.: Lo"f.):i ~~u!'s Q~ ~\.I.D.J ~ ~ Telephone #: ("i4'::) tn-J,Q.~lt'\ FAX #: (~S):u:i.. <o~~~ Email address: SPECIFIC DESCRIPTION OF RECO'RD: Any correspondence, notes, memoranda, documents and materials submitted by or concerning the Foundation for the Chapel of Sacred Mirrors and/or Alex Grey. PORMA T OF RECORl:> (if available) -.--.... : .-. . ......... ." " .. ... .,.: 1 request tQ be notified when I can come ta inspect the reoord(s) described above o I nKlue.t copies of the record. deBon~ _~ve ~~ agree to pay the cost of such [~rd8 in