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144 Received by: Chris Masterson 0 Christine Fulton gr- Sue Rose 0 i:- / Uo- / ..1L ( L.\ l./ 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Date Received: ~ VWAPp ..:... ~o ~~-.-...-.,~+.. :;.....' ,~, ~/'- >,~' "....: .~, o,~t~ c:. . 1 . .,1'.' /~ , (I.', . "..\,.:' ~. . . ''':''4.. 7~SS' co~"I;'" FOIL Ser. #: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER OF TAXES 0 RECREATION D/, SUPERVISOR rg TOWN CLERK 0 WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: / / Date Applicant Contacted: (init) / / Date FOIL fulfilled or denied: nit, / ,( {Ij(~ Closed by: Date: s- II' / II --- Notes: LJ,,,+-~i-~ ~C\&N\ Ln ~P\-(M M~ pceJ~t\t> ~~~. Amount Due: Pages for a total of $ Name: Address: o check here if you are requesting that the records be mailed to this address. Agency or firm: Telephone #: ( Email address: ) - FAX #: ( )-- FORMAT OF RECORD (if available) o I request to be notified when I can come to inspect the record( s) described above tr" 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