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272 OCT/18/2011/TUE 10:07 AM FAX No, p, 002 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 Sue Rose 1Y" Date Received: / 0 I / r / 11- FOIL Ser. #: 1!/)7{). <. 'tNAPP-' ,.: 0" ",,'--, '1~.', 1;~~" ',~'l'", /~, " " ":,, """, \ i~/ " ""-~~~\ "\""o\~'I~1 ,c.. \1ItI1If~ PCI \,~' ~ )..,,,' ',,'," ' '.' '" ' , '~~s,._-"'<'~,~!J ,~. S ~()v' DEP ARTMENT: ASSESSOR ACCOUNTING CODE ENFORCEMENT PLANNING FOR DEPARTMENT USE.ONi. Y !Q.1!f11! Date Received by Dept Department Head approval: FIRE INSPECTOR 0 ffiGHWAY 0 RECEIVER OF TAXES 0.. RECREATION 0 , SUPERVISOR 0 TOWN CLERK 0 WATER/SEWER fr DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN A TIORNEY 0 Date Applicant Contacted: - (init) I I --- Date FOIL fulfilled or denied: I I -- Closed by: D~e: ~/lfT~ Notes:.Aft' ~ ,dV..ah Amount Due: Pages for a total of $ FORMAT OF RECORD (if available) ~ 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 he faxed to the number listed above o o