019
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
L/3-L/.-U- ~
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR TNTERNAL USE ONLY
Received by:
Date Received:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT l(
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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(init)
Date App~:m ~J1l4ed: i-r :3 I I !..l-
Date FQlL fulfill~_~enied: L I 3! I II
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Closed by: ,-( V
Date: L I 3 ( / .!.!-
Notes: /1 /jJ, @ .; 5~ ~ Itf2';
Amount Due: _ Pages for a total of $
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Name: (/1,,/
Address: I u L S:CPI/~ (lV~ .
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Agency or firm: ;' / '
Telephone #: (g y( ):!:.1L- 8;;f/ e FAX #: ( ) --
Emailaddress: Jr/,A-"vc.IN"t- 1,/ d !Uv!lf,l(.N,4r
o check here if you are
requesting that the records
be mailed to this address.
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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