144
Date Received:
Chris Masterson 0
Christine Fulton 7f
Sue Rose 0
01 /1.11) ilL
J0/LI
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECEIVER 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
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Date Applicant Contacted: 1/& / /0
Date FO~~ denied: ~ / Lt... / LQ.
Closed by: # f
Date: /Y i 1_ J. .:]/ .& / LIZ.
Notes: ~
Date Received by Dept
Department Head approval:
Amount Due:
Pages for a total of $
Name: 15)t\ AtJ S[V\ I TK
Address: z~ :1J;t- 5-'\
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Agency or firm: j?l\J'AR ~
Telephone #: ( ~~t") -1 ~ b - II t'O FAX #: (
Email address:
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o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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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