204
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
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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:
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ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATEWSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept -:i. / -1- / , ()
Department Head approval: ~
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: .-51- / JL / ilL
Closed by:
Date:
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Notes:
Amount Due: ~ Pages for a total of $ (j, 5V
Name: G ,f-ty rt1 ew I) L.~
Address: ~,L.v l: ,... 1'1. ) II;
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Agency or finn: jIV2 'CV--I) \. " f- M{ 0 G-<. ~ .
Telephone#:(~"3) 'ilY - 1k"J- FAX#: (2-~ )~-hl(
Email address: Q It.. J-t c.. "'" IE I} t. e ~L . C ~ .
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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