023
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
fL/ J:1/.JQ
~
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
FOIL Ser. #:
DEPARTMENT: ~
ASSESSOR 10'
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 "2.J JJ / Jb
Department Head approval:
(init)
Date Applicant Contacted: _ / _ / _
Date FOIL fulfilled or denied:~ -.L C
Closed by: (
~/!J-.L6
Date:
Amount Due:
Pages for a total of $
Notes:
Name: :5eYl",;f'.d Hc,f')f"') . /'J'15 Def4 c?fVat15.
Address: LJ $LI~VI'i'++ . IS Ivd
0.7 (II 0] hX-c t' ~/ ,.. 1\)1/ I d rd.. o?
Agency or finn; f\) l.(~ Dept. (If TTcm~,tbr-fc;-I/0i7
Telephone #: ('3' l/.f) 575- - ,",Oq I FAX #: (~l.fS ) :;-'5" -
Email address:
o check here if you are
requesting that the records
be mailed to this address.
6117
SPECIFIC DESCRIPTION OF RECORD:
K .p ~ 5;} /, ~ {(-ecA! .f{(l~rI r T 1'0. ns:.r:/ i<"'fc)/f a ...,/ Deed !;.?r
-f{6~{{ ~ 5q/rr fax fClrcel WS'1-0-o - ScJ?,?;t)&> on 1;)/1// oc(: .
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