190
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845-229-6338
p. 10
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FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose 'GI'"
Ji/d/jJL 0
190
2009-10-16 rCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
fOR INTERNAL USE ONt. Y
Received by:
O..'I'I~Pi>I",
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bate Recei~ed;
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
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 ~
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
I
Date Applicant Contacted:
(init)
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Date FOIL fulfilled or denied:
Closed by: . r-: d',-J
Pate: ~~V
Notes:
/ I
/ /
Pages for a tDtal of$
Amount Due:
A=;;11;f~~~1oc.~ .
Agency or firm: Lo.(,J.) ~~t.es a ~ <e..tvanwJ 1;'. ~
Telephone#:(~4~.z25..: ~~~ FAX#: (~4s)'Z1..-=' -<ns<...~
Email address:
o check here if you ue
requesting that the: records
be mailed to this address.
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 (ifavailible)
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 oftbis application
o I request that the reoords be scot via c-.mail to the address listed above
o I request that the l'e(;(lrds be faxed to the number listed above