035
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0,/
Sue Rose )1\
3- / ....l / & '-----'
II- :s~
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING g/
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
of( ~~l
~~' ' ".+....,
...oJ:" A . .: - "I". ,
0,' "~.p\
,.-' '
I : " \~\
,~",~,;z:1
,~' /.;;..,1
C' ' ',' ~.
~~._./~,,+ .
5S cO'V
Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept L / .J.- / /0
Department Head approval: ~
(init)
Date Applicant Contacted: ..2. / 3 / I D
Date F~denied: 3 /.3 / 10
dC-Jz
Closed by:
Date:
;if 3-/ /0
~ 1(7. y~)
Amount Due:~ Pages for a total of$ 3 -.3~
Notes:
Name: G I <~I)ot-\ '00 G~
Address: \ 0 e e.c::. +k MILS ~Q
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm: LU A.P e I "-.)<1 evz. '> A 'I r.
Telephone#: (qlc.t ) ~6' - 71-,r FAX#: ( )--
Email address: COACI:-\ <- C3M4tL. c.t;~
SPECIFIC DESCRIPTION OF RECORD:
~evle tV Or j?t41V 5
FORMAT OF RECORD (if available)
~
o
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
o
o
Sii'Speed}!
Invoice
508
Printing and Marketing Services
Sir Speedy Printing
1708 Route 9 . Wappingers Falls, NY 12590
(845) 298-8898 . Fax (845) 298-8537
email: sirspeedy8571@optonline.net
No.
79730
Date
3/3/10
o INEZ MALDONADO
.... TOWN OF WAPPINGER TOWN HALL
Q 20 MIDDLEBUSH ROAD
o WAPPINGERS FALLS NY 12590
'"
P.O. #
2
Engineering copies NEW HACKENSACK FIRE DISTRICT 0 line, 0 inch
336
Sales Rep'. Rebecca
Account Type: Charge
Thank you very much for your businessl
File Originals
Ship Via:
Wanted: Mon 3/8
Engineering copies NEW
HACKENSACK FIRE DISTRICT
SUBTOTAL
TAX
SHIPPING
TOTAL
AMOUNT DU
3.36
We accept VISA, MASTERCARD, AMEX,
3.36
3.36
Please pay from this invoice
Thank you for your business.
o Pick Up
o Cash
o Delivery
o Charge
o Other
o Check #
Amount Received
I I
Received By
Date