090
FOR INTERNAL USE ONLY
2009-]0-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton 0
Sue Rose ~
Date Received: 3...... 1 l 1 -1.L
FOIL Ser. #: q 0
DEPARTMENT:
ASSESSOR 0 /
ACCOUNTING rM'
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
4- 1 <{ 1 'I
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(init)
.:LI LI.iL
Date Received by Dept
pepartment Head approval:
Date FOIL fulfilled or denied: !:L 1 jl 1 ~
Closed by:
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Date:
-.1.1 lLI JL
Notes:
Pages for a total of $
Amount Due:
Name: t3~r bo. r~ G u + ;z../ e.-r
Address: 5 tu. s S' e-r La. I'l e.
Wt1fl'; 11 ~ fA) Ht Ur NY.' 2. 0tJ
Agency or firm: -
Telephone #: ( fi II.( ) t{ M - Lf ,;uo FAX #: ( 'i(q(") .?2 q 7 - 5 ~ I {;-
Email address: b vt + 7-1 fA @ ~;
o check here if you are
requesting that the records
be mailed to this address.
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FORMAT OF RECORD (if available)
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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 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
I request that the records be faxed to the number listed above
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