028
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ~.:..
Sue Rose 0
03-/ /0/ JJ.-
-JJ ~ <f3
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR ':B
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING . 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR J
TOWN CLERK J
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / .Li}/ -1i
Department Head approval:
(init)
Date Applicant Contacted: d Ijt) / i.L
Date FOIL fulfilled or denied: a. / jQ / JL
Closed by: f#3
Date: 0 tiJ- / J.L
Notes:
Amount Due:
. .-
Name: /c Or 7 If' L.:"-' /(/ /~. r 0 check here if you are
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Address: ~ " i:.. .Ji?J fl r / 7' 5'T"7 requesting that the records
C:" ; 'f ... ,{ {I ; I- 9 T "t/' ?~ / i ,;; t I be t;nailed to this address.
Agency or firm: N/ (';f / q.>' /for~' /' /?7 <" ('<P7 a ~ '7' /l/'/' ,.u ' r"..j
Telephone#: (72'1) llL- c:r iq/ FAX#: (7..z'1-) ?"/? - r(~J
Email address:
I SPECIFIC DESCRIPTION OF RECORD:
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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