246
TO: 845
P.2/11
NOV-01-2010 15:34 FROM:
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
JLI3-ILL-
~
2009-10-16 JCM
TOWN OF W APPlNGER
App)jcation for Public Access to Records
FOIL REOUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING lJ
ZOffiNO ~
FIRE INSPECTOR n
ffiOHWAY n
RECEIVER OF TAXES 0
RECREATION n
SUPERVISOR 0
-TOWNGLERK. - m []
W ATERlSEWER El
DOG CONTROL OFFICER 0
TOWN ENGlNEER 0
TOWN ArrORNEY 0
Date Received:
FOR DEPARTMENT USE ONT~ Y
Date Received by Dept
Department Head approval:
1 1
(init)
Date Applicant Contacted: _I _I _
Date FOIL fulli1led or denied: lilt 10
Closed by: ;'
- !-. .__ __ _ __m
.. ..... .... ..-...-.-.-..
1_1-
Date:
Notes:
Amount Due:
Pages for a total of $
Name: E\ ZAbE:....~ ~~-\-t- L.... 0 checkherc if you are
Address: '1-.'~ (.Cl.r ~,e C~~ Jeque~G that .the records
1> (\~tL "to'"' .~ O~~4 0 be mailed to this address.
Agency or firm: E U V ,,2.0 U JA..,,\-<,A"V'&>I"t,, ~ \ Corp.
Telephone #: ("0-\ ) 2.L-t~ - .,~ -2.~ FAX #: (100:\ }t;dL- Ol~
Email address: P..x,~v"'- ~~~v~"'o^-("cr ~. co.--.....
SP~CIFIC. DESCRIPTION OF RECORD: - -k
__ ~rt.~ rv\o.-k~. -to ~ \-€CJ.-.. A;"" <i\;~
0. - \rL.:~ o"~ ~ . . 't)\oc.~ '-I Lut' <0"\ \
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FORMAT OF RECORD (if available)
o 1 request to be notified when 1 ean come to inspect the record(s) described above
L } I request copies of the records described above and agree to pay thc cost of such records in
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
o I request that the records be faxed to the number listed above