005
Received by:
Chris Masterson
(Christine Fulton~
Sue Rose
OL / ) q /CKJIO
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
IVI::L FOIL REQUEST
9 2010
FOR INTERNAL USE ONLY
Date Received:
JAN
FOIL Ser. #: E)
ENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREA nON
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
_lJ 1!i / J1L
~
(ini t)
Date Applicant Contacted: _ / _ / _
Date FOIL €fil~or denied: -.-L / & / ~
Closed by:
tJiA
---l / tl / --.LL
Date:
Notes:
Amount Due: y,D Pages for a total of $ fl. 9J
Name: t--l()~ \ CA- t\N ~ \A-S
Address: 2 -\N w~ Q:, t?- ~ dS t.. I2-d .
\0&\ ~P""~.u ~ r=-c..\~~
Agency or firm:
Telephone #: ( ~4. S) "Z.-tt~- \. C; '&6 FAX #: ( )__
Email address:
check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
...
FORMAT OF RECORD (if available)
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