130
Date Received:
Chris Masterson 0
Christine Fulton ;(1
0e R~se 0
t:i!:l / IlL
j?LJ
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING r
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK ~
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
to / 'Z<f/ (0
W
(init)
Date Applicant Contacted: ~ / Z r / ~
Date FOIL fulfilled or denied: (;, / tI/ ~
Date:
f&A-
(p / 1J; ( 0
---
Closed by:
Notes:
Amount Due:
Pages for a total of $
Name:
Address: ,., ~ i ,.. . V
... fI P I ~ ~'Ct C "" $ 313
Agency or firm: 5 e I tf"
Telephone#: ('t"!C)ff!itJ~/O FAX#: ( )--
Email address:[5CJ1.<11..erll @ d'" /Yi J1-! hie 0 h1../
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESC~JPTION 9FRECORD: ~
~V~~ ~
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