037
Received by:
Chris Masterson 0
Christine Fulton ~D
Sue Rose
'7 /)1/6
6-~_
-p::-3i
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
o~ VJAPp
~~." ":'~,~"'~
5'1< .< >\~\
,....,:. ~'11.
"t:'.'l~' . l>-.\.'
~" . /z,l
, C'.t:., . . ,,' r".)",;
'7e-ss"co~~ '
FOIL Ser. #:
DEPARTMENT: _~
ASSESSOR LV
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER 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 J- 1 i 1 -.L()
Department Head approval:
Date Applicant Contacted:
(init)
1 1
Date FOIL fulfilled or denied:
1
1
Closed by:
~~
~/~;lD
((DdYv (( -
Date:
Notes:
Amount Due: -1- Pages for a total of $ ;;) C')
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
. 6;1'\
SPECIFIC DESCRIPTION OF RECORD:
~,61-0 (JA~ h~~ 7Htr
r
A5'"--S e,-::z.s- G\o'\" J CJJ F-r--/ t:. r
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