081
Received by:
Chris Masterson 0
Christine Fulton ~
Sue Rose \J
~/&r...1 JL
#fl
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
0(( VJ~",
$'~' ...::'+t;' "
.0./ ., ~1f'
.... "'.
0\ .' l~
c:.,~. . /2:.'!
,;..\(> , . /.:1
.1..,. .!~
''7~ -....-.. -,"'" .
.55 c()'"
Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT g
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
LI",7S! II
H4
(init)
~/.;z51 II
enied: .J 12SI/ /
Closed by:
He-
Date:
.3 12.51/1
---
Name: 51:: rr t1 f Y /'VI j:: A.v L:::-~ 0 check here if you are
Address: 9..) I J.. Lo IV# 1/ /t'/.J C /(/05 '(Nt> requesting that the records
W4X II It IV A/ G ~ ?/7.3 be mailed to this address.
Agency or firm:
Telephone #: ( 1/7 )? L/R - ~Jr F;\X #: ~ )_-
Email address: .:rEF rA c 'f '/'1 j: A..v L: Y ~ if A 1700 , C () ~
SPECIFIC DESCRIPTION OF RECORD: )
'7 L/ keN f rOt<
w 1-11 "/>J5,- N'J' ;-It //$, A/ r
l/ ./'
t -f / -- - ~
,-( j - o.,-~ ;;t ~ ()
FORMAT OF RECORD (if available)
)(
)r
o
o
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