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246 L 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 ,e Rose g.- Date Received: /dL/ -1L FOIL Ser. #: ::/;fi..'7 'y' h ~ WAPI> .~~."--........~ ~/ .:~'""f;'\ :0': ..-~ .... ," , o' .' \> c.~/:r' ,A /.,1 C", '.,A..' ...~~-.."~.,. ~ . 5s co-u DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT '--w-- PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGBNVAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK 0 WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 Name: Address: I cA u- f'C.. b () ~f}'rr/r;ve J Agency or firm: ' Telephone#: (g~ )2a7 -67-7) FAX#: ( Email address: f o check here if you are requesting that the records be mailed to this address. )_- ;7 06 - 3 s--s"'-~ SPECIF53lC~ ~CORD: . a l . .: 3/'7 ~~ / (p~ c; -01 - do(, 90;' 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