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249 NOU-01-2010 15:35 FROM: TO: 845 P.S/ll FOIL Ser. #: Chris Masterson 0 Christine Fulton 0 Sue Rose ~ -U-/~/~ d'\~ ~c. . n\ r-' ti~)' l 2009-10-16 JCM TOWN OF WAPPINGER Application for ~ublic Access to Records FOIL OUEST v FOR INTERNAL USE ONL Y Received by: Date Received: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING 0 ZONmNG g FIRE INSPECTOR J{ lliGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 ~- -'-fOWN-CLERK:--- - ---P-----.El--------~ WATER/SEWER 8 DOG CONTROL OFFlCER 0 TOWN ENGINEER 0 TOWN A TIORNEY n FOR DEPARTMENT USE ONI.. Y Dale Received by Depl 1/, ~ Department Head approval: (imt) // 0: / 0 Date Applicant Contacted: _I _' _ Dale FOIL fulfilled, denied: / /, ~ (CJ CIOScdby:tY/_ ~- . Date: ~ II 1 / 7 II (J Nnles:!l-hus ,.J iJt ~;;& Amount Due: _ Pages for a total of $ Name:~\ZAbe.-~ lL~~l.... 0 check here if you are Address: ~. 14 (Ar~ e. (~~.,.....- requesting that the records l' .,-MLe..... ~...... ~ O~t5y 0 be mailed to this address. Agency or firm: €:' U V 1 12..0 U ~ ~..r~,. - ,,~\ (or,). Telephone #: (",o~)2L-t~ - .,~~ 1..3> F^*#~(~~ )~- 01.~11 Email address: e .f ~ '\-l '^" ~ ~ ~ v ~ roo-" C or \' . (E........... SPE~CJFIC DES.CRlPTlO..N OF R.ECORD:.... ---- . . ~ ~ ~r~ r'.A~. ::J \4.....-- \~G" ~r ---<;\;~ ~ - \ ".tt- G\ . b\oc-~ LJ L~ (0 \ / . FORMAT OF RECORD (if available) o I request to be notified when I can come to inspect the record(s) described above o J request copies of the records described abovc and agree to pay the cost of such records in accordance with lhe fee schedule on the back of this application y:( 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