089
Received by:
Chris Masterson 0
Christine Fulton 0
S,l.\e Rose ~
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0 .
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
4. /~/1JL
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(init)
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Date Applicant Contacted:
Date FOIL fulfilled or denied: Jt / 13/!....!L
Closed by:
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Date:
Notes: ~() ~p;es V'e~red
Amount Due: -1l.- Pages for a total of $ 0
Name: ' r te e 0 check here if you are
Address: c,u'lV\. . UvJ La- requesting that the records
IfV\ eM J-r D ~ vy f'A/ ()-{ll1 be mailed to this address.
Agency or firm: C I+-- <;
Telephone#: (g;(()cML-7<t0l2 FA{{#: ~y\) '11f) - {.p(Qb3
Email address:UpVlJvlt.tv~h...vc . /"" (' ~1v"Vl
SPECIFIC DESCRIPTlON OF RECORD:, 0
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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
~ 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