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252 (2) FOIL Ser. #: Chris Masterson 0 Christine Fulton 0 s~e Rose \Or 1&11L 6 1P-QJ6c2 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Received by: DEPARTMENT: ~ ASSESSOR OJ ACCOUNTING 0 CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 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 ~ yJAPp o "-~.-.,.... ~.t, ~~'- ...", .'.:1;"./ .' :.-;,.::~' .'0/ ...-.,:> '.... ( .... .., \. ..'..o....\~.~... .J>-..I ~\ . :z ;..a. ;,j,...! C' .. rA,,' \~~)is- co~~ . Date Received: FORDEPAR~~SEONLY o~Cf(:.~ Date Received by Ntl5t (. ~I - 1 - Department Head ap~a'\: \J ~. s>~\~~tit) Of \tJ ~ Off~ Date Applicant C~~O~ _ 1 _ 1 _ Date FOIL fulfilled or denied: / I --- Closed by: #3 Name: T L '/ .It{ S H A tl t - Address: ~ 1tfL;.r;;;~ z".'ll ~fj~ 'f~~ . N'1 I '2-S-~ 't) Agency or finn: ( Telephone #: (~)) b.3v 2--"2..-3.DFAX #: ( )-- Email address: --- I I ges for a total of $ o check here if you are requesting that the records be mailed to this address. SPECIFIC DESCRIPTION OF RECORD: 6D P"B 1- )}V-{' FORMAT OF RECORD (if available) o I request to be notified when I can come to inspect the record(s) described above ".5/ 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