046
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton 0
Sue Rose \[:y
..3-1 JLlLiL 0
1{c.j(p
Received by:
Date Received:
FOIL Ser. #:
04(.~~1.'
.~.~. ",.",~
:gA ,<>\~\
I'" .:' ~ ~ \
IO!'~' 'f.~~
.c::.' . /z'1
....... I,. i
C> " ,," i
,:.i..~ "_ >' .1:-1'
"7":S5"co~";-
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECENER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER, 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
o
o
o
o
o
o
o
~
o
o
~
FOR DEPARTMENT USE ONLY
1 1
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
(init)
1 1
1
1
Date FOIL fulfilled or denied:
Closed by:
1
1
Date:
Notes:
Amount Due: _ Pages for a total of $
o check here if you are
requesting that the records
be mailed to this address.
Name:
Address: i (J~
Ls t
Agency or firm: l e,,- 0, .t.. f 41> J
Telephone #: ( 91 y) 2-6 l.. - cJ> J..rj' FAX #: ( ) _-
Email address:
SPECIFIC DESCRIPTION OF RECORD:
\~ II~r~ L)..J
1.-/) HA:Ld '-VluE' M
W. I.
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