270
FOR INTERNAL USE ONLY
Received by:
ChrisMasterson 0
Christine Fulton 0
Sue Rose '''E
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1t-ChO
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0 /
SUPERVISOR t9".- R70
TOWN CLERK ~
W ATERISEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FORDEP ARTMENT USE ONLY
Date Received by Dept !.!.- 1 f'!- / ;;J,.-
Department Head approval: ~
(init)
Date Applicant Contacted: _I _I _
Date FOIL fulfilled or denied: / & I:J I 1 JL
Closed by: @)
Date: 10 1 dL/ 1 ~
Notes: 5 ~ .z.- e.e.-U <<s <e:... -s-dvc.-
Amount Due:
Pages for a total of S
Name: p.e,.{;:e.v \b~K..--
Address: 2D(p ol,b ~P~Cu~ (Z..o4-Q
w It () P I U c.." ~ f=A-(.)J 1-1'/ t
Agency or firm: $'a. l,p.
Telepbone#:(!~) ~- rrr.r FAX#: (' -#7-- -
Email.address: ~
o check here if you .are
requesting that the records
be mailed to this address.
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FORMAT OF RECORD (if available)
1 request to he notified when l.can come to inspect the record(s) descn"bed above
1 request copies of the records described above and agree to pay the cost of such records in
accordance with the fee scbedule on the bac1c 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
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