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267 FOIL Ser. #: Chris Masterson 0 Christine Fulton ~. S}tfl Rose 0 !.Q.1/JJ..llL ~{n1 2009-10-16 JCM TOWN OF WAPPINGER Application for'Puplic Acpe..ss to Records FOIL REQUEST .. EOR INTERNAL USE ONLY Received ~y: Date Received: ( .....<.. '-'~!'~"~~)' ~ , . ,; \ItlAPp o ......, '-\: ~~.'~' ':.~'..:--~" 0/ .\<1) .....' .,' it:l,-~)\>-.". c:, " . ~ ;,' ,:.l>..' co " . .... . ~('ss' CO~~ DEPARTMENT: ASSESSOR 0 ACCOUNTrnG 0 CODE ENFORCEMENT g/ PLANNING g/ ZONrnG 0 FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK. 0 W ATERlSEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATIORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept I 0 1 !.1... / !!- Department Head approval: .1::fJi::. . (init) Date Applicant Contacted: L!!...I / 6 1 J.L Date ~ denied:L!!.-1 al II Closed by: lit- DMe: ~ Notes: (5 - t!!-I Lt/ // Amount Due: Pages for a total of$ --- . ~":. .' Name: :To 1, ,,_ () l ~ \ H'J01I Address: [ ~ '2.) ~ "" ~ \Y LCrr'~8~ 111tL .' tJ-f (7. 01n Agency or firm: Hrl/1 ~ (au.""" t1 - fLuvt ~~ - Telephone #: CC[LL/ )::J::iJ-.- ~~ 1 FAX#: (~f ) ~- 'I 77Lf. Entail address: :TO I; \rl'.I/'a.@ !-l ou I i 1'1411 1-0... LVf'en ce . c~ "" o checkhere if you are: requesting that the records be mailed to this address. SPECIFIC DESCRIPTION OF RECORD: -gv' 1 cl,,+:,ll- -t2w- ILl \l.Ilutv... DtiVf- t (P;?o 7-0rJ- -7S-S'j/--:J FORMAT OF RECORD (if available) ~ I request to be notified when I can come to inspect tberecord(s) described above o I request copies oftbe 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 f>omail to the address listed above W I request that the records be faxed to the number listed above