073
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 15f
Sue Rose 0
03 / 3J J L!L
'73
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
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
WATEWSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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(init)
Date Applicant Contacted: _ / - / ~
Date FOIL fulfilled or denied: 3 / 51 / / C
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Closed by:
Date:
Notes:
Amount Due: Xpages for a total ofS X~
Name: A.JlLVLL 0 check here if you are
Address: (Q, Y"l~'; yv\ V'f\Q l ..(;vU l {)...~ requesting that the records
,mE ~ \)~'''I.~ _N.../ I ;)~'l ~i ~e mailed to this address.
Agency or finn: r2 c ---'l~'~ ~ _ 2- Ma::r ~ VV vZ/
Telephone #: ( hD !.dtL- 1-f22> F #: (W() -114- 1.0 (p La3
Email address: '0 f (o ,1\ 1f~.J) (4) k vi L . V (. C 0/V1
SPECIFIC DESCRlPTIO.J'l OF RECORD: , A
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FORMAT OF RECORD (if available)
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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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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