Untitled (2)
Received by:
Chris Masterson 0
Christine Fulton iJ
Sue Rose ~
1-/ lS.1 ~ C>
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING . 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECENER 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 Appli~,tacted: .L II ~I 0
Date F~~or denied: -L I /S I I 0
Date Received by Dept
Department Head approval:
Closed by:
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Pages for a total of $
Date:
Notes:
Amount Due:
Name:~~..I; "'-IL 'fhI=t~ lk. ~J
Address: J (r A~ ~ ~+,
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Agency or firm:
Telephone #: ( ) _- FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
C (') P ( 1 cTb -~ )c:>'t- \1Q.-v, %-I I 7 CA. cl(Q/W\ ~ 'S '\-. LD~ ~ ~ 0 -<J 1'1. ~.
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