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237 Received by: Chris Masterson 0 Christine Fulton 0 Sue Rose .... 0..- LI d11.JL <J 1/,93 7 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Date Received: of( VJ..!-.?p, .!!i:~,~" ',>"'~' ~/ ' ". 'l~' ~i ""~ o'~' \> c::.,',' ,,' f~,'! ~ r'....' (I' , ',A.. ~~ss"cO~~ ' FOIL Ser. #: DEPARTMENT: ASSESSOR ~ ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGH1VAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK 0 WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN AITORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: _1../ ;l3 / 1L ~ (init) Date Applicant Contacted: _ 1 _ / _ Date FOIL fulfilled or denied: ~ / ~3 / /1- Closed by: fJlltfr J./ 431 .1L Date: Notes: Amount Due: ~ Pages for a total of $ V. J <;' Name: (! 1/ C,t'{Z ~J (111 '\ Address: v\,.6 %l ~J.l \~ (l9 WGw ~ ~ ...t \' f -Z-n"'D Agency or firm: c~ ~. A1 P(2(~t \1t'l,) Telephone #: (f'fj ) ~- 'J.. 7o:.~ FAX #: ( Email address:(.elM~tlL("e.We.(t\t.UY1 o check here if you are requesting that the records be mailed to this address. ) - SPE !FIC DESCIW)}ON OF RECORD: /) , ~t rY (ll,-C ofl:Y c,~ V +~)(.. ~A-'r Zl--- ~t<<"1L 11 {h ~ ~ I Sl~~ I~L\ 1 FORMAT OF RECORD (if available) o 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