306
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose . ~
~/ 21 JL
~&6(P
2009-10-16 JCM
TOWN OFW APPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR []
TOWN CLERK []
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER []
TOWN ATTORNEY []
FOR DEPARTMENT USE ONLY
Date RecefG.~Q.,,~ BrPt _I _I _
Departmeu~i&~PINGER
2.0 Mjddl bRIg OFFICE (init)
i IIf ... e ush Road
Date Appii~rl.?JtWe\&!"S, N. Y.l1259O--
Date FOIL fulfilled or d~EIVeD 1_
Closed by: DEe ~20"
Date: TOWN OF W A
ASSESSOlrS
Notes:
Amount Due: ~ Pages for a total of $ i / ~
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
220
Agency or firm: V I h--ef J...e. rvl..L.{., JIl1.. .
Telephone#: (f"1/'1)JJJ.L- ItUbl FAX#: ('1/4 ) 3Ltf(- 4/cL 1-
Email address: .. . ,.J i u.-. I"'V1 db, (v 1- '-V\ + L Lc! VL-\
SPECIFIC DESCRIPTION OF RECORD:
/rjr I2e-vI-e q - W ct / f J.~ 11. j
I ^,Y r'Ntp
.v.? r "IO...l l i~ h { t y c{ COt t-~
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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