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FOR INTERNAL USE ONt Y
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOILREOUEST
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Received by: Chris Masterson )(
Christine Fulton 0
Sue Rose 0
Date Received: / Q.-101...1 ~
FOIL Ser. #: ())d5
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/
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT )&
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY U
RECEIVER OF TAXES 0
RECREA nON 0
SUPERVISOR 0
TOWN CLERK ~
WATER/SEWER D
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
10 I ,,~ / 10
~
(init)
~I/ 1-/10
Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: -1 -=- / -=-
Date:
v;}( G- K
rrY 11.-llL/fD
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Closed by:
Notes:
Amount Due:
Pages for a total of $
Name: ultlil'l H,,".u-VVl""-""
Address: \?~()O ILlV.(..y"S"d...L 1>f.1t.2D...
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Agency or firm:"Dt.Y~i-t ?\"CJL
Telephone #: (~Ii ) ~- ~bc.,
EmaiJ address: CV\C4.11 e 1'1'\""..... .;,
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
r:: 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
t.. I request that the records be sent via e-mail to the address listed above ..{.\~v is f.w'-..l.
){ 1 request that the records be faxed to the number listed above