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122 FOR INTERNAL USE ONLY Received by: Chris Masterson 0 Christine Fulton 0 S~ Rose ~ ;L/9-/jL -:jf Io? /) Date Received: FOIL Ser. #: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING ~ ZONING ~ 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 Name: Address: 2009-]0-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST . o~ VJAP"" '~~' '. ":,",,,",,1;' ~/ . ",- ;;:~\ ..... .:~' ~'.~. ,l>, ~" / ;,:,' C" . '. r -A.: :I.,~.._ ;..'..>..4. 7~SS"C()~"I:" FOR DEPARTMENT USE ONLY Date Received by Dept s' / .J ~/!. Department Head approval: _ (init) Date Applicant Contacted: ~ / ~ / II Date F~l~enied: Sf 3 / / ( Closed by: /{ rY Date: d~ ,5'/ <3 / II Notes: Nil (1y.LM ~ Amount Due: Pages for a t6tal of $ o check here if you are requesting that the records be mailed to this address. ~AX#: ~5 )SS!L-OD hP SPE;~D~O~ 8~709:b ~ Or I-)))K ~ ~T OF RECORD (if available) ./ ~~est to be notified when I can come to inspect the record(s) described above / est copies of the records described above and agree to pay the cost of such records in '/ ce with the fee schedule on the back of this application ~ "'that the records be sent via e-mail to the address listed above # \at the records be faxed to the number listed above