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185
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
. FOIL REQUEST
Received by: Chris Masterson
Christine Fulton
~e Rose
Date Received: L / /02 / ~
FOIL Ser. #:
/116
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DEPARTMENT:
ASSESSOR
ACCOUNTING ,
".
CODE ENFORCEMENT ./
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG-CONTROL OFFICER
TOWN ENGINEER
TOWN AITORNEY
FOR DEPARTMENT USE ONLY
Date Received by Dept Z / 1ffI'
Department Head approval: .
mit)"
Date Applic~t' Contacted: 7 / ~ I (
Date FOIL fulfilled or denied: 2'/@j;j/
Closed by:
Date: :2 / /5/ II
. Notes:
Amount Due:
Pages for a total of $ .
Name:~~
Address:) . ~~/ )
/,eI1tfJ/lJ~..R rif-~ /Jet /vrf";J
Agency or firm:
Telephone #: <1LIf) 140 - 0~l FAX #: ( )_-
Email address: milt JIJ.~_ ___~Y).# (;D ,CZU
check here if you are
requesting that the records
be mailed to this address.
SPECIFIC D~CRIPTION2F ~ORD: 'iJ'p Ie ~t \ fA
~t14>t, ~ ~dfi '?1~ ~-~1"~S
~ < ~~'ltl " 2bl' -/.br~ ,Jay /2,71:>11
FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the record( s) described above
J 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
.SlIP 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