221
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by: Chris Masterson 0
Christine Fulton 'P
Sue Rose 0
Date Received: /lL /I{l:l / JJL.
FOIL Ser. #: ~1
~ ~APp
, ~~. '.-"~"~.-t.
,.~/ ,,:.-~~'
.:;...0./ "'~.'
.,.j~.'."}'~.\.l
,0 .'
c::.' .~.
'. ~ / j,.'!
C'..t. ' ,F " .'
'''7~ss-CO~~ .
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECENER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
o
o
o
o
o
o
o
o
o
~
FOR DEPARTMENT USE ONLY
Date Received by Dept 10 / O!d / 10
Department Head approval:
(init)
/ /
Date Applicant Contacted:
---
Date FOIL fulfilled or deniedn./ - / -
Closed by: lY-
Date: I 0 I NIl 0
Notes: ~u~uofl ~~
Amount Due:
Pages for a total of$
Name:,4 IJ~ Js K;
Address: if /J1 /) /-IA- k1 jet. ]) I? IV t:
tJA-jJ/Jj#t:-lil{~ ~Ati.-; 1'1 V
Agency or firm: - SEt- F ' I
Telephone #: ('-If~ ) ;l. 'I 7 - 3 ~1 t FAX #: (
Email address: _d
o check here if you are
requesting that the records
be mailed to this address.
)--
SPECJF~RlPTIONbF RECORD: t ;f, )
I ;5 tJAf'17Lb "I-- ~ :/.NIJ
FORMAT OF RECORD (if available)
~
I request to be notified when I can come to inspect the record(s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
o
o
o