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206 FOR INTERNAL USE ONLY 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST Received by: Chris Masterson 0 Christine Fulton ~. Sue Rose 0 Date Received: L / 6lq 1 .!.L FOIL Ser. #: C) 0 l.p o~ vvAPp/ $~' . -:-:'~~, .0/ ,..':::\~' I~\~'~' c,'\ . }z;! ;.Ac- ' ,,I ,J..'/ ~~>u._ >,t" ' ss c()~ DEPARTMENT: ASSESSOR rJ1 ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR J TOWN CLERK [] WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN AITORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: J/~-,LL .JJur- (init) 1 1 Date Applicant Contacted: Date FOIL fulfilled or denied: 1 1 Closed by: ~tl~ .::ll ~ 1 11- Date: Notes: Amount Due: ~ Pages for a total of $ tJ ,~ ~ Name: Address: ~fqL~G~ . b9 MJt ~., tiif2tl ;.) r fl! c ~If Co ) . \G - ? h FAX #: ( o check here if you are requesting that the records be mailed to this address. Agency or firm: Telephone #: ( Email address: )-- SPECIFIC DESCRIPTION OF RECORD: i t:-CfA'- I)!?5C ,e/~ 7/0 P r~1--\ I>~&!> Prlt<.C bl- t>>J U:6tc. Kt> v ()tJ )cJ 4e j2e- FORMAT OF RECORD (if available) o 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 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