005
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton )?j
Sue Rose 0
Date Received: 01- 'fao 1 11..-
FOIL Ser. #: 5"
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT )Q'
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept I 1 ;;Ci / r
Department Head approval: - #6-
(init)
Date Applicant Contacted: L 1 ,;l c' 1 !..!....-
Date FO~~~~ denied: L 1 UI / LL-
Closed by: H &-
Date:
LI.2i21 //
Notes:
Amount Due:
Pages, for a total of $
Name:
Address:
check here if you are
, requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
:1~~~1o ~~t2lw,a
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