137
Received by:
Chris Masterson 0
Christine Fulton ~
S~ Ro~ 0
CLL 0:2 / lJ2
/30
2009-] 0-] 6 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK CV
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept Ql /D'6/ j 0
Department Head approval: - ~
(hili)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied; / /
Closed by: &.
Date: (J] /rx / t ()
Name:
Address:
Notes:
Agency or firm: uel I 3d]
Telephone#: (t4(')~J~/O FAX#: ( )_-
Email address:Bc..1t/)1E.Q..4~G-...IlI~ I Co ht
o check here if you are
requesting that the records
be mailed to this address.
SIfC"L1C DESCRIP:bON OF RECORD: J
/ ih?', ~ eb.s e.u /f'h. hi lis ~~ <::",0 rre,s f~11 de.l?t.e ~
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