216
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
1- I r2.J.. / !.tL
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT: __ /'
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
o<fc W~PI
~ffW':"""''' '
... " .., - ~ .
;0 ( . . '. ..-fl'.
I....". \
I.I,.~.}.~.I
,o,~. .
c:;.\ . ~.
~ / J...I
C" ".4.,/
,~~s.~._',;~':...~ '
''',' 5 CO'"
FOIL Ser. #: rO/ b
FOR DEPARTMENT USE ONLY
Date Received by Dept <:l. /tfi / 10
Department Head approval:
(init)
Date Applicant Contacted: _ / _ / -
Date FOIL fulfilled or denied: .f EJ3. / -1J1
Closed by: ~
Date:
---
/
/
Notes:
Amount Due:
Pages for a total of $
Name: /2of>~1 ':>C/~ '"'.oS /<F""L. 0 check here if you are
Address: ~ 2- /,,/~)~ ~ Ir.:><..(;: .t-._~ requesting that the records
.2!>~ t:='-...) .;-c;:--~ be mailed to this address.
Agency or finn: /~~/~ ~/,-q.4,.s <...
Telephone#: (C6~)~- ,110' FAX#: (~'-l-r) ~l. - S~ >L
Email address:
SPECIFIC DESCRIPTION OF RECORD:
;z=i~ ~~ :2 y- /~A-.-.. Lc-/ ~.
FORMAT OF RECORD (if available)
o / I request to be notified when I can come to inspect the record(s) described above
wi' 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