201
AUG-31-2010 11:23 FROM:DONOGHUE THOMAS
8452276361
TO: 845 P .1/1
U if) fa:{.; "'2JI'6' - I tf7'il
FOR iNTERNAl, USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Ma!>ter!>on n
Christine Fulton ;"1
S~e Rose ::~
y "2' "
Date Received: :L-1 ~A / ~
FOIL Ser. #:
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/ "'"Vv
DEP ARTM I':NT:
ASSESSOR U
ACCOUNTING 0
CODE ENH)RCEMENT 0
PI,ANNING 0
l.ONIN(j U
J-'IRE lNSPECTOR U
HIGHWAY 1.1
RECBIVER OF TAXES IJ
RECREATION 0
SUPERVISOR 0
TOWN C1.ERK g
WATEIVSEWEH. 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATfORNEY 0
FOR DEPARTMENT USE ONL Y
Date Ret~eived by Dtlpt
Department Head approval:
I
(init)
Date Applicant Cont~tcted;
f
Dale FOIL fulfilled or denied: f I
n 0 DOIJ~p 1--0 \ -- -,--
(jodbY: J:x-.u) iJ2 WI",:) 0
Date: 8- / 3/ / /0
Note!>:
---.-.-.---....-- -_._."._.._----_.._~.._--
Pages for a total of $
Amount Due:
Name: L'f"n 9Ibulsk.,' U t~heck here if you are
Address: 2.sn ilClU~ n requesting that the record!>
_,_~~(( C)cmc.-hen, N'i 12.$ '3'3 be mailed to this address"
Ag~ncy or lirm: ~~kWoll.. 'lltGMa<;lI. t4us/~r t i)roh."
Telephone tf: (~5 ) ~ ..,0/ S "AX #: ( )_-
EmaH address: 'co bul~~, et~..,t.."" ,,&t
SPEcrF'IC DESCRIPTiON or RECORD: I
CbP1'"- 6+ curl&'\t GS8'\ CO\~'U,..t.. invlu&L'~ .:>~ 'aI\.i. s.hQ~(eS'
FORMAT or RECORD (if available)
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I request to be notitied when I can come to inspect the rtlcord(s) described above
I request copies ofthe records described above and agree to pay the cost of !>uch records in
accordance with the fee schedule on the back ofthis application
I request that the records be sent via e-mail to the address listed above
I request that the r(~cords be l~\xcd to the number listed above
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