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247 NOV-01-2010 15:34 FROM: FOR INTERNAL USE ONLY Received by: Chris Masterson 0 Christine Fulton 0 Sue Rose 1! JL/~/JJL d~\ Date Received: FOIL Ser. #: DEPARTMENT: ASSESSOR 0 ACCOUNTiNG 0 CODE ENl~ORCEMENT 0 PLANNING J( ZONING (J FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER Of TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK~. O~. ~ WATER/SEWER B DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 TO:845 P.4/11 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR DEPARTMENT USE ONI.. Y Date Received by Dept Department Head approval: 1 I (init) Date Applicant Contacted: .iL 1.l.1 /0 L/h Date FOIL fulfilled or denied: L.!...I .!lIlt) tv'!; Closed by: /~ ! ...- - ...... ~_. Dme: __1__1___ Notes: Amount Due: Pages for a total of S Name: E, zg.. b~~ lt ~;--(.. ~ 0 eheck here if you are Address: '1-14 C Ar~ L C~~ rcqucsting that the records 1> <Mt..L"'\'o '"' ~ ~~'S4 () be mailed to this address. Agency orfmn: EU V ,,2..0l) ~~i-~lo1~\ ("~f)r Telephone #: ("ol\ ) 2.L.i ~ - 4~ l..~ FAX #: (~Ct1 )~- Ol~ Email address: e~~\'t()"'- eel ~v~ '-o"-t.o[" ~. ('o~ SP~IC DESCRIPTION OF RECORD: _, ~ ' ' __~ .af"~ t't~0- i-<> ~ \~V~~,..- "'''*'I ~ - \ ,,"\-t..- C\ . bloc. ~ Y Lo+ CO \ ) . y - l.j- / 0 AjJf~ i!d!fff ~' ~\il g ~ o FORMAT OF RECORD (if available) I request to be notified when I ean come to inspect the record(s) described above 1 request copies of the records described above and agrcc to pay the cost of such records in accordance with the fce schedule on the back of this application 1 request that the records be sent via e-mail to the address listed above I request that the records be faxed to the number listed above