051
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
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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:
DEPARTMENT:
ASSESSOR ~ #..0.
ACCOUNTING 0
CODE ENFORCEMENT ~ - #0/
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENEROFTAXES 0
RECREATION 0
SUPER~SOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOIL Ser. #:
FOR DEPARTMENT USE ONLY
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Date Applicant Contacted: --.i. / l / ~
Date FOIL ~ or denied: ~ / l / L1-
Closed by: <)'1'> M ~ }I{ L
Date: .l..- / ~ / ~
Date Received by Dept
Department Head approval:
Notes:
Pages for a total of $
Amount Due:
Name: J., JJ ,.~"- milS h"''1 0 check here if you are
Address: jj.~ {e,,+ Ut IIUl ./f~ I, V",.,. t requesting that the records
A I bit *' '" I./'t IV Y #wI<:. I U ~ fJ b~ tpailed to 9llSj jid. dress.
Agency or firm: /",1 MJ e.U ~ 1\ ~ ____ C ()(p1 t ;(ocr ~
Telephone#:(1/t )llJL-,4rJ-FAX#: ("., ).JuL-11.lt'6 .
Email address:' Jl f (.4 . tI ,. ...,
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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