102
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton ~../
Sue Rose cs
l/&5[1 J.Q.
IO~ + )d'S
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR ~.~ J Q P-
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES ~ / () S
RECREATION 0
SUPERVISOR 0
TOWN CLERK. 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
A 1.a9. I ~
1-J~
(init)
I I
Date Applicant Contacted:
Date FOIL fulfilled or denied: A- I ;tCl I ~
Closed by:
Date:
3-1 dfjl ilL
Notes:
Amount Due~ Pages for a total of $ 1.:l .,
Name: 75~52.f+7\.Al)[ L SeW [11.../5
Address: 1'-/ 0 ~ ~-I-_!"') :y . 'Y (/ i ";} (00
--,=7: h ;. / J / .;;2.3- L(
Agency or firm: ~ U-l eft (;;;:-lIh/45 t<fAZ (
Telephone #: (<6'1',) i2!iJL- ~CC) FAX #: (St{5) at:
Email address:
o check here if you are
requesting that the records
be mailed to this address.
-?:J902-
SPECIFIC DESCRIPTION OF RECORD:
C~"'~/ .-j-. '-/~-{/J /YD
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