280
12/30/2010 08:40
84548&7881
TOP BUILDING DEPT
PAri!:. 111/81
FOIL Scr. #:
Chris Masterson IJ
Christine Fulton U
Sue Rose ~
ILj~j J1.L
-trc) Rv
2009a 1 0-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
RS FOIL REQUEST
CEIVED
~ DEe 302010
~~...
~UIt'>I\~!T .
~tN~
FOR INTERNAL USE ONLY
Received by:
Date Received:
DEPARTMENT:
ASSESSOR [I
ACCOUNTING 0
CODE ENFORCEMENT 'Kl
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR [1
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY n
FOR DEPARTMENT USE ONLY
Date Received by Dept 12- I .3? II () .
Department Head approval:
(init)
Date Applicant Contacted:
---
/ I
Date FOIL fulfilled or deni
Closed by:
Date: l2--j ~ It)
Notes: NO $O~Oc>c.'\)~ .~
~\~ ,\ \ ~O'f.t'l ~ '1E.cfIIJ
Amount Due: Pages for a total of $
Name: ~\Jc.e: f""\-c:"_'~12.
Address; '"7.0. ~ ~'"
_~~~Scrl\J\~ \ Nt" \i..S3"t
Agency or firm: ~~~SoMU\I..l.J:. F"~ "bb1"(~""
Telephone #: (&-\S- ) ~- ob3~ FAX #: (MS") 192-- t/S~
Email addl"ess:~I$-~ \.1,0 @ 0-0\. c.c.M
U check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
cot^l Jr ~ ~1"iF="rC.A"'e ~ OCc.u?A~C"; F'c~G .,-~~ HA""-
2.0 ....,..\~~:a~ ~o9'-.'0 \ ~.p."l?\~c.I!;iC. f"'-',,-,; 4 ~~ ,'\..S"to
FORMAT OF RECORD (if available)
n I request to be notified when I can come to inspect the rcc01"d(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 ofthis application
o I request that the records be sent via e-mail to the address listed above
I R ll"equest that the records be faxed to the number listed above