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196 FOR INTERNAL USE ONLY Received by: Chris Masterson 0 Christine Fulton 0 Sue Rose .~ .l/JG/ JL ++-/9<. Date Received: FOIL Ser. #: DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING .0 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 A TIORNEY 0 Name: Address: Agency or firm: Telephone #: (~S.) Email address: 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST . o~ VW~.!:1>>1. ~~.';~' ."~''''~' 01 ",:::-,~' '.,...: ,~ 0\ '. l> c:.....~}~ . ~ ,.' . (1.6:'. '. /A..: '7('ss'co~+- . FOR DEPARTMENT USE ONLY Date Received by Dept 11.201 t I Department Head approval: - P1 c:-- (init) Date Applicant Contacted: ~ 1 VJ 1 I ( Date FOler denied: 21do 1 LL Closed by: H C- Oate: --; . ~/ ~O/..:L Notes: Cof..u-o ~a~ Amount Due: Pages for a total of $ o check here if you are requesting that the records be mailed to this address. .11 FAX#: (~~) 5SQ- 00 &d" SPEcmCDESC~r~pe~~r~ I / (; 0 51-EJ-f - (//9 /tJ ;i . FORMAT OF RECORD (if available) ~ 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