241
FOR INTERNAL USE ONLY
Received by:
Chris Masterson ]
Christine Fulton ]
Sue Rose .~
J-Q.. / Jlr..1 ~
a~1 +J4)
Date Received:
FOIL Ser. #:
DEP ARTMENT:
ASSESSOR 0
ACCOUNTING [IY' - 02'-t I
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES D. / _ ') \,j '/
RECREATION g./ - 0- [ ,;-
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(irtit)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied:
/
/
Closed by:
Date:
/
/
Notes:
Amount Due:
Pages for a total of $
Name: b~. ~.. ~! ~ ~LiIKILy.J2.J checkh.'re if you are
Address: _ ----'- _' (l ~ _ _ requestmg that the records
r' ~ /VY be mailed to this address.
Agency or firm: ?~oI~/~ /.F~~
Telephone #: (~. )~-"'IJ'lO FAX #: ( )21;l Jo7/
Email address:~.JI!iA.OrVJ~S~-~..h~t7nl:A.7Z.1t:..7~/?/L
/
SPECIFIC DESCRIPTION OF RECORD: .
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<. _ ~:... ~-;;; ~5Y:::~~;~ ~~
7k ~.~ /4~ erP ~~.Y\ /-4h~ ~//e~ I t7~o.J-c.
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FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the record(s) described above
I request copies of the records described above and agree to pay the cost of such records$
accordance with the fee schedule on the back of this application ~
I request that the records be sent via e-mail to the address listed above .1 }.J()+ .
I request that the records be faxed to the number listed above
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