008
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by; Chris Masterson 0
Christine Fulton 0
Sue Rose .g-.
Date Received: iJ I / Jo 1.:20"
FOIL Ser. #: if>?
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECENER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONLY
Date Received by Dept -L I eX () I J.!..-
Department Head approval:
Date Applicant Contacted:
(init)
I I
Date FOIL fulfilled or denied:
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Closed by:
~yY)
LIdo IlL
Date:
Notes:
Amount Due: ~Pages for a total of$
Name: f'1/J IC-(H,q s/ ~G M U AJD 0 check here if you are
Address: ...2D eft fCH I::::; L If ~ TS . requesting that the records
WPr P(O,/lJGE::125 FAu...,5:. A,J\ / J~qo be mailed to this address.
Agency or firm: f /
Telephone #: (et.f~ ~- rg~Lf FAX #: ( )_-
Email address: H5ld,@ cJ=rlJJJU NE . A/t;T
SPECIFIC DESCRIPTION OF RECORD:
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SeAJoR CeMrER- -BV'Dc.Ei '1> EiRiL -paR... .toIO f :Loll
FORMAT OF RECORD (if available)
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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