002
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
L/lL/JL '
1f;)..
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
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 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 -L / LL 1 .J..L
Department Head approval:
Date Applicant Contacted:
(init)
1 1
---
Date FOIL fulfilled or denied: -L 1 J..L / ..l-L-
Date:
rv~A-
-1-1 lL/LL-
Closed by:
Notes:
Amount Due:
Pages for a total of $ (). <:)0
Name: ,..< 0 check here if you are
Address: / 9 ,:f' 't /l..g I .of fr' S- L requesting that the records
-;f:A. r. ~' ,r..bLc ,.'/ Ljl- y /l ~-s.3 be mailed to this address.
Agency or firm: tIi:; {;t, 4~ /,i1-wC.(r>? c €-
Telephone#:(JYS-)~- ~.P>(; FAX#: ( )--
Email address:
SPECIFIC DESCRIPTION OF RECORD:
:2.t. ~tlA 5'7 d r <J II DOl IN r1~ i~/ <-31'S ~/ /.F
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