082
Date Received:
Chris Masterson 0
Christine Fulton V
Sue Rose <:::::)
~ / c2l. / ->>-
:t=J- (?J
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 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
o~ yJAPPI.
.. ~.~r. ~~""',,,
lj/ .,- ~~
"0' -,.
'....' .' \ \
.o'\~~>:i
c::.. j:r'
,A / ..../
C" '. " " .
~(>'''#''-'~ -
5s CO'"
FOIL Ser. #:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
~/~//
~
Date Applicant Contacted: ;J / ZS / / /
Date F~if!!~ed: .3 / zS / ~ /
Closed by:
He;
.3.. / 2-5/ //'
Date:
Notes:
Pages for a total of $
Amount Due:
Name: ..::::r ~ r r 11 c 1 /"'1 C -1/1/ E ~ 0 check here if you are
Address: t? .r / J.. L.- 0 Iv' cf L/,' rw c- / f/ S lJr/.It requesting that the records
W At I-{ A-W j A/ C, d. f /73., be mailed to this address.
.
Agency or firm:
Telephone #: ( r /7) 7 tiP. JR..3r FAX #: ( .J
Email address: .--:::r 13 FFI/ 13 \.f' ~ C ,1-11/ e '( ~ --p;;;:~oo , C O--^1
SPECIFIC DESCRIPTION OF RECORD:
~ J f1o..6/A/ L4IVc'
till Ir/~ """'I ~fJ Fq / lry IV r
t,~5}'~O/f' - tj/~/~
FORMAT OF RECORD (if available)
,h\ 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