143)/1812013 12:42 PM From: EnTech Engineering PC / (646) 722-0000 To: 18452981478 1 0
FOR INTERNAL USE ONLY
Received by: Michael Leonard
Jessica Fulton
Date Received: ,~ / z~~~~
FOIL Ser. #: ____~~„
DEPARTMENT:
ASSESSOR ._~
ACCOUNTING
CODE ENFORCEMENT
""~
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OC'FICCR
TOWN ENGINEER
TOWN ATTORNEY
2009-10-16 JCM
TOWN OF WAPPINGER
Application far Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept /~ / 3 ~/
Department Head approval: .,~f ~
{init}
Date Applicant Contacted: /O/ ,~o //
Date IL ' or denied: !~ /,3d / /3
Closed by: n n
Date: r~{-~j J[ ~ 4 / ~ / /3
Notes:
Amount Due: Pages for a total of $
Name: Jam KA~s heck here if you are
Address: ~,~,~,'i r~ ~ ~ ~t~T '~ t~x.~v requcstin~ that the records
`hy~l_ 1,t„'xx1-.~ be mailed to this address.
- ..~ ~ ~,
Agency or firm: = - 4 t:r 4tV1
Telephone #: (~, N (~) •~' Lti - rX.,~ 7~ #: ('Ll ~,) ~ - r.~~,
Email address:,~k~:.cxS,k;, 3 ~, ,~ "~
_. ._ _
P~~SeSSo~ ~ SPECTFTC DESCRIPTION OF RECORD ~~'~Sp.. e~~ti~.t~~4N `k Z-1R ~~' ~:~ ~3~t1 k. t \.c~~' ~'t''Q+";
--`` ^~~1 r(~~ ~.~`
~~r~r ~„~t'i_LS•~~L ~ ~"w l ~~t t.7C ~. C~~ ~ ~~ .~t~~.,c.~ ( .~r'~~ .~- r"7l'~~8:-~
~~n`~ric~ .~ - ~, t u ,.,.. `~(r C. , ~- ~~uv r '4r r1 x •~`« 1 ~ ~
~)~.u~Yb.__.~.r.~(rur~~ (k~ TaS.i~:~4.~~},V_~~.1~~~g, ~.~4 1.~.~ ~:..~.r:Cs.~c'. L
Ct+ ~~ _S.L~'~ U1h_1k~~l,Y~} 1~110~ l'IY~;,~-~'~^~nUZ.I__.lyL1...,oL,j~L{~y~. ,,,.,,J~a,~. Y ~ t ~ ~ '
FORMAT OF RECORD (if available)
I request to he notified when T can erne 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
~e~~,, I request that the records be sent via e-mail to the address fisted above
I request that the records be faxed to the number listed above