144)/1812013 12:42 PM
From: EnTech Engineering PC / (646} 722-0000 To: 18452981478
FOR INTERNAL USE ONLY
RCCeived by: Michael Leonard ^
Jessica Fulton ~j
Date Received: ~ / ~7~~~c,~
FOIL Ser_ #:
DEPARTMENT: ,",,,
ASSESSOR ir!"~~
ACCOUNTING
CODE ENFORCEMENT ~ ' "~~"~
FLANNING
ZONING a;,:;~ ~'~~
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OC'PICER
TOWN ENGINEER
TOWN ATTORNEY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQ UES~'
FOR DEPARTMENT USE ONLY
Date Received by Dept __._ / _
Department Head approval:
(init)
Date Applicant Contacted: ,~,,,,,/,_,_,_ /
Date FOIL ful fi Iled or denied: / /
Closed by:
Date: ~ / c3 r~ / ~ 3
~' /~
Nolen: v•~ ~'II Gu ,~
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Amount Due: Pages for a total of
__ _ _
Name: ~~~, ~~ heck here if you are
Address: tit ..~u~~~ r '1.13 "~ t~,r;v requesting that the records
~~' ~ ~ 1~1`~~ tt '~~, he mailed to this address.
Agency or firm: = t L ytV "~'
Telephone #: (I,p,N(o) ~~- ~ :x'~ •. X #: (~Ll Z) - d~,
Email address: '-44.cxr,~: W. s3v~~~~ ls~ -''i~`.. ~~svu,
~~SeSSot' f SPECiFiC DESCRTPTiON ~pt~ RECORD:~1~'S2. ~.W't~tt~Y'^ `r Z~R- ~~4`r' `~s'~~"~t3~ik-t~.c~~ ~'r'er;
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FORMAT OF RECORD (if available} %7 t.~ ~~ ~~~ ;~~U~-~~
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I request to he notified when i can ecrrne 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 be faxed to the number listed above
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