224
FOIL Ser. #:
Chris Masterson 0
Christine Fulton '-5
Sue Rose 0
112-/ 61 &-
;::y Ov(
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING )(
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK )9.
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
()~ yJA.!p, '.
....~~..~. .~.~~\
:o/' . -~..
'II- f'. '. \
"0\ . ,,' '.l>-:i
,e.\~' }2:1
.~ 14.1
(I .' ("4,,!
'~-E' ._.__.~'.,-~ /
_s~coV
Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept 10 lrol 10
Department Head approval: ~
'(hiit)
Date Applicant Contacted:
1 1
Date FOIL fulfilled or denied: jQ.... /02 1 ~
Closed by:
Date:
1
1
Notes: ~ ~~
Amount Due:
ges for a total of $
Name: SC!.. ilY] ,f..."Z.. 0 check here if you are
. Address: a ~. 1/ I:' requesting that the records
Agency or finn: ;" ;'~~.f r ~ }':r e r " '1' "" f ,/" be mailed to this address.
Telephone #: ( &L1.SJ .~'rr - :/../ I ,'J FAX #: ( . . )_-
Emal'laddress' /1., ,1/; If" t r!.7.i, l''-'' Jji\{.\ "'1/'..1 ''''?~! 1
. .,..1 ';. ','.' i /y"," \...('.. ,,/ ._-f ~ _! [j , 'N" ' ". '.- f ;
SPECIFIC DESCRIPT~ON OF RECORD: I I
~. 0 I J.. rf:~ r' ~., .1'\ .} j ;," r" l3 (A, rt " '(I'~-' --
v
.i ". "" Uc ~r~j;,.QA4J 0.. ~,d g{e~ -lll"~ t t
l c.-' /I. Ir I
~ C! rr eSf{' 1-1 d c' 11 Q <Z.. l ;'"'~
......
e,1(Jt(;, !;"~"'! ,"fh:; rir'?J~ i ;i
(/
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