063
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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 0
Sue Rose ~
Date Received: 3- /11-- 1 J.l.-
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTmG 0
CODE ENFORCEMENT ~o
PLANNmG
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
2-/~/D-
(init)
<--
5 / ?- 1 -.!..L
Date Applicant Contacted:
Date FOIL fulfilled or denied: S- / Z I!!..-
/! tf-
Closed by:
Date: N~,
Notes: ~
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Name: Ltrv
Address: fl v ~<o/"\ y r-e _
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Agency or firm: .-
Telephone#: (7'/0/ )1!dl--~ FAX#: (
Email address: t, 1Zvle/~ /1 ~ ~bJL t"........,
Amount Due:
Pages for a total of $
1-0 0 check here if you are
requesting that the records
be mailed to this address.
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SPEC~C DESCRIPTION OF RECORD:
rlt.,/J1 ('11 -(:y-,
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I/--Irlr -WD .f'VY
FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record(s) described above
f{) 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