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017 Received by: Chris Masterson 0 Christine Fulton 0 Sue Rose V -L/~/JL G -t/l 2009-] 0-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Date Received: , o~ WAPp. /~~. ~~!-t. . "IE" f,' ..: - ~~\ ,;~ / . .' ,~\ 1 ..' \I~\'.~" ' '. )~j ,;,l.(;I . . j.Jt...i ,~. . ,. . / A.. ,,' '7~S-""-'~ _\.~ . ", ,S cO" FOIL Ser. #: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT Y PLANNING rr ZONING 0 FIRE INSPECTOR 0 HIGHNVALY 0 RECEIVER OF TAXES 0 RE~REATION 0 SUPERVISOR 0 TOWN CLERK 0 WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN A TIORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: o II ;2>11 II --~) Date Applicant Contacted: 0 I 1;;2f; II ~~:9 denied: 0 ( I d.-151 !L Closed by/ I({/ - ..,Date:,-/ 2.i1 Ail !.L Notes: Amount Due: Pages for a total of $ Name: Address: o check here if you are requesting that the records be mailed to this address. o SPECIFIC'pE~GRJPTION OF RECO~:, \ f. ( t to I:i..e.Ldsmf'R ?i VD (}.I~rp~8(S mJ s ~. \.(, tz:;tfo , &;157-/0 -;2 .s~ro Iv FORMAT OF RECORD (if available) o I request to be notified when I can come to inspect the record(s) described above o 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 o 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