039APP,/02/201;; TUE 10; 47 APB Conrad ~eoscience FAX No, 845 454 2655 P, 001
FOR INTERNAL USE ONLY
Received by: Christine Fulton
Jessica Fulton
Date Received: ~ / ~, /
FOIL Ser. #: ~~
DEPARTMENT:
ASSESSOR
ACCOUNTING ^ ` '
CODE ENFORCEMENT ~ ~v1d~ '
PLANNING ^
ZO ^
IRE INSP TOR .
HIGHWAY
RECEIVER OF TAXES 0
RECREATION ^
SUPERVISOR ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
aqg--1178
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~ //~
Department Head approval: ~~Y ,
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Date Applicant Contacted: ,/
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Closed by: ~"~~'
Date: S l~Y' l /.~
Notes:
Amount Due: Pages for a total of $
Name: CPS - 2 ~. ^ check here if you are
Address: ~nr~. Ci v~ t CC'.n,~2r Pf rxza . ~v; ~e.~a j requesting that the records
la o~ 1c cue Sr' C~ J`,' Z D I be mailed to this address.
Agency or firm: QV L ~ e er-
Telephone #: {5~+5) LfS~i - 2.7~ FAX #: (g~1s) ~/S~i _ Z65S
Email address: ~ IctroS e @ s~vesti~F~'ler_ coy,-~
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
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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
~,f I request that the records be sent via e-mail to the address listed above
~j I request that the records be faxed to the number listed above