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210 I 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 0 Sue Rose %' Date Received: L / ;L / .J.L FOIL Ser. #: d I 0 DEPARTMENT: ASSESSOR g( ACCOUNTING []' CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHNVAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK 0 W A TERlSEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 o~ w..~~1 ~.~< . "~''''~.' ~ .' .,," ,~ ' ,'0/ ..",,,,"~ '.-: ' .' ,'O\~l~' c;...'. .. .. i z;. '. /~..I C" '.'''''' ~~ss" co~~ ' FOR DEPARTMENT USE ONLY Date Applicant Contacted: ~/~/lL ~ (init) / / Date Received by Dept Department Head approval: Date FOIL fulfilled or denied: ~ / 2- / 11-- Closed by: J.' flA .:6...... / ~ / lL Date: Notes: Amount Due: i..tJ- Pages for a total of $ -' ~ ~ o check here if you are requesting that the records be mailed to this address. SPECIFIC DESCRIPJ'ION OF RECORD:_ fl ~ 5 .1.J _ A PJ{.EJPfii-J'ZTi ,RE'LOR.D5 lot/' ~~CJ8 ot17rt n1/ef}'--'e 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