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068
Received by;
Chris Masterson 0
Christine Fulton 0
Sue Rose W
o /1J.-3/ 10 6
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTmG ~/
CODE ENFORCEMENT B
PLANNING 0
ZONmG 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 A TIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
3 / ;1.3 / J ()
~
Date Applicant Contacted: 3 / ~J / ;0
DateF~ denied: _ / _/ _
Closed by: II. ~
Date:
3 /;;3/ /cJ
---
Notes:
Amount Due:
Pages for a total of $
Name: ..5 he.. \ \). \ ~ +6\ca:l
Address: 41 d\L ~.i-t 8l-LU.e.-
WAf> PI of)~(S {\..y 1&-,"'1'
Agency or firm; -
Telephone #: (~~. )'d. '-~ ).. - Cfl.( 1 ( FAX #: (
Email address: Au i\T SlAt':l \/LO;}G1 &GL 'C~ ,
o check here if you are
requesting that the records
be mailed to this address.
)--
SPECIFIC DESCRIPTION OF RECORD: ,
~ l-oL<>i'-..k ft-h~'~~<>-~L. ~'i" t~~~ ",~..,.
. ~~~:: ~~. "\ ~~"-'~<>-~~ ~ ~'"r "~ ~,~
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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
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
