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Received by:
Chris Masterson 0
Christine Fulton '1J
sZe Rose 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
0(( VJAPp
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING ~
FIRE INSPECTOR 0
HIG~AY 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
FOR DEPARTMENT USE ONLY
Date Received by Dept If{'/ :lh./ J1
Department Head approval:
(init)
Date Applicant Contacted: ~ / U / ( /
Date FOIL ~ or denied: -1. /le / R
Closed by: ~ 0
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Date:
Notes:
Amount Due: Dages fur a total ofS.---
Name: ~-"""'~~4-J;'f' 0 check here if you are
Address: ~,,~ {' j,1"L 1-,,-,-, P,f.d. requesting that the records
Pe..Lx":Sk,'//, Al, y. ~,,~ , be mailed to this address.
Agency or firm: "Bt> .g '-'it~ l~04..v;~
Telephone #: (l, 3/ )~ ~ ':270 FAX #: ((;31 ):3d.!i. - :!J 7/t>
Emailaddress: g~D~6 IVlle /f'OO,(Dn') 1-0; c:Jf'ir.,t.1I1L_C@ Yuhoo~~
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
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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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above