111
Date Received:
Chris'Masterson 0
~hristine Fulton ,tj'
I
Sue Rose 0
.'5 If{1 JD
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #: I / /
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept !25i I? I .L!!-
Department Head approval: ~
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Date Applicant Contacted: os! i%.. I L2-
Dale F& denied: 0->'/ t!.J / ()
Closed by: ~ 116- /S' 1J
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Date: ~t\l S- I If I /0
Notes:
Amount Due: ~ Pages for a total of $; 7 S-
Name: (5(LvbCV1. - J CUv/JI'-
Address: ~;Iall ~..{AC-L" 1Le~,~
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: (9IY)~-d93J FAX#: ( 7'1<f) c;tJ-- -&;r'l1
Email address:S..a.wlk..~~.~~YeA.(..e.CD .r----
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record(s) described above
o 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