262-263
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton ]
Sue Rose .~
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Received by:
Date Received:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
I I
Date Applicant Contacted:
(init)
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Dale FOIL fulfilled or denied: -111--1 -
Closed by: M-
/
Date: LL I 1i. 11.2.-
Notes:
Amount Due:
Pages for a total of $
Name: fJ.~~ Scl.~
Address: J 8 Hi I · e...
af~ Jl ;t.I-.s ~ AJ.'t1
Agency or firm: I e.. ~ .
Telephone #: (~J) H:L-1'1/U FAX #: ( )_-
Email address: c!-R JtI Ell t!c-JI t2 Q /i111/k I'c..O '^-
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD: I'" h d 8 ' , { cL
al Vo<!. e~3C(k. , .sC\.\.\.
C~""l-eS Po'vaenC!.e I.-o~
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