260
FOIL Ser. #:
Chris Masterson 0
Christine Fulton J
Sue Rose ~
11-/ /S' / ~
I)~ 0
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 iJ
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR J
TOWN CLERK. J
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY !J
o~ ~~!:.~I
~~' ' :~,'t~,'
~ / ' " ::\~.,)
',~: "
'0\ ' ' , \,.'
c:."'~}Z:!
....C' ' ,/.J..~I
,:I.. "_ ' " .1:0.-
"7("55 "co~'<;""
Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied:
/
/
Closed by:
Date:
/
/
Notes:
Amount Due~ Pages for a total of $ 6?) i
Name: S A ~..Y~\A 'to\. A1\\ uR "- }
Address: S 0 C / RRO \. \ \ r-'
~ t ) A{J P, ~ \ \" {\.J .~l (d-;:) 7 0
(
Agency or firm:
Telephone#: (~'-hl~'7+- ~-'--I~ d.-FAX#: ( )_-
Email address:
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
\:--\-0 vt 'S --e 0 <? e d
FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record(s) described above
K 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