238
Date Received:
Chris Masterson 0
Christine Fulton :J
Sue Rose d./"
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING g
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES fJ
RECREATION 0
SUPERVISOR J
TOWN CLERK J
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY !J
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
10 /1-sJ/o
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Date Applicant Contacted: /0 / ZSI /0
DateFOIL~enied: /0/ Zs/ /0
Closed by: ~ (j
Date:
10 / 2)/ /0
Notes:
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Amount Du~ Pages for a total of $
Name: r..U\fo..l "':S~e;.I.1~
Address: n<.- ,~Ell l-bllo,"-, <..~
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Agency or finn: "scAo ~urv fo.... - ~
Telephone #: (6 \\) quo _4"5 3 FAX#: ( )_-
Email address: ~ 1:: v\ N fY\ ~ ~ It.''t..\I \~ t. A ~u. ~
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requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
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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
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