106
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
S~Rose 1('
..Q I !:II E
tI/dP
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR yJ'
ACCOUNTING 0
CODE ENFORCEMENT 0
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
~ v./APP,<\:
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Date Received:
FOR DEP ARTMENT USE ONLY
Date Received by Dept 6. I .:J. I 10
Department Head approval:
(init)
Date Applicant Contacted: _ I _ I _
Date FOIL fulfilled or denied: ~ I ~ I /0
Closed by:
Date:
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Name: Clife(s~ MI4~,c.o
Address: tt1 ~ ~l . \Ill" I v t:f '
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Agency or firm: '
Telephone#: <bY)) ~- .J2IJI FAX #: (
Email address:
o check here if y u are
requesting that the records
be mailed to this address.
Notes:
Amount Due: _ Pages for a total 0 $
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SPE~lFIC DESCRIPTION OF RE90~: !/~ ..j)
C' (Afr~-f ILpfra:;sa'f . ~ t~
I I
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