023
FOR INTERNAL USE ONLY
Received by: Chris Masterson 0
Christine Fulton ]
Sue Rose 'K
Date Received: ..8- / l / ~
FOIL Ser. #:
fT,;?3
DEPARTMENT: I
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES J
RECREATION 0
SUPERVISOR J
TOWN CLERK J
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY J
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept il / 7 / 1/
Department Head approval:
(init)
Date Applicant Contacted: [) / j / I /
Date FO}L fulfiiled~r denied: rl / '7 / / (
.. r-,
411-
/J VV
.2./2/1/
)
Closed by:
Date:
Notes:
Amount Due:
Pages for a total of$
Name: ~.e\~,uc:... 'QOsc~tl -1)~
Address: 3 ~ 0 ~16 .ut')I'~ Av-e.
W 111~-.k. PI tl...{' V\-<"; , i-J\..{ I ot.;o S
Agency or firm:
Telephone #: (91f.{ ) '.007- d~ 8'S FAX #: ( )_-
Email address: "(' Ld u.. '1' -e.. w), ~
o check here if you are
requesting that the records
be mailed to this address.
( /-'1 I' j'" . {
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SPECIFIC DESCRIPTION OF RECORD: I
\\1'" ~~ ~o (L:~.) <Y\ h~-;
(-+ ~iC\ve l Urrj~~. 8--) I I ;;:LS9D
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 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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