155 (3)
FROM :SAMY
FAX NO. :2274291
Jul. 29 2010 12:52PM Pi
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FOIL Ser. #:
Chris Masterson 0
Christine Fulton .~
Sue Rose 0
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158
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL RE9UEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR
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Date Received:
CODE ENFORCEMENT
PLANNING
ZONING 'CY
FIRE INSPECTOR ~
IDGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR ..~
TOWN CLERK '0' _
WATER/SEWER 'i{
DOG CONTROL OFFICER ~ /
TOWN ENGINEER 'E1'
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONt y
Date Received by Dept ~ 12fl. / ( D
Department Head approval:
"I (init)
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. Date Applicant Contacted:~ ..:1/ ~ I R
Date F~ fUlfi~l;)or denied: L I;).. I /0
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Closed by: 1-1 U-
Date: 1:-/2/ /0
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
\~3 be mailed to this address.
FORMAT OF RECORD (if available)
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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
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