202
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ~
s~e Rose ~
/31-1 I2-
doe.
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
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Date Received:
DEPARTNlENT: ~/
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
ss... 1 21 1 .l.D-
..wYr
(init)
1 1
---
Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: ~ / 8/ 1 lJL.
Date:
1JtZ.k
~/2.l1 1JL
Closed by:
Notes:
Amount Due: ~ Pages for a total of $ {b. b.If
Name: jJ\ i '- \-'1 A (,1 r~ v s-)' 0 check here if you are
Address: 9.:).f; ~ \ \I U Ro II. c\ tJo r P'\ requesting that the records
(AJ~pP 1""4l.....~ ~~l\~ l JJ i ,~S '10 be mailed to this address.
Agency or firm:
Telephone#:(c?'1~) fJg - ~8'l17 FAX#: (S?~f1~-2.333
Email address:jVlF"^\.Iel.c 7 ':L A-D I . C ,p./"l
SPECIFIC DESCRIPTION OF RECORD:
pvro-{~"\"', fr~.pt"ry "'3~1f ~~'t1t ~;vtl- ~II.A-cl
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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