088
Received by:
Chris Masterson 0
Christine Fulton~D
Sue Rose \
Jl. / G.. / 10-
#~
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 0
ACCOUNTING ~/
CODE ENFORCEMENT 1!1"
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
Date:
FOR DEPARTMENT USE ONLY
Date Received by Dept ./ / 13 / 10
Department Head approval: ~
(init)
Date Applicant Contacted: 1- / &. / ~
Date F~ denied: !/.; tL / !JL
Closed by: ~
.-f/rJl / 10
f1r~
3 CCJ{J' \u
Notes:
Amount Due:
Pages for a total of $
Name: MA'i< MO ~
Address: 5eul, l V
C'ff u,Wl J'4.. , Rl/
Agency or firm: c~f1 f>o'7f;i'l(Qt!../f/'e..'
Telephone#:(f4' )!Lf.L- r7r3 FAX#: ( )_-
Email address:
o check here if you are
requesting that the records
be mailed to this address.
~!C DESCRIPT~ OF },BCORD: ~ 9- k/; ~. 6-
# D~f tJJ- I H't-, ~ W1~ ;j!LI vy /
~3S-r:- ~(- 0,;271tS-
FORMAT OF RECORD (if available)
" 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