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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by: Chris Masterson 0
Christine Fulton 0
S~e Rose ~
Date Received: ~ / ~ / JL
FOIL Ser. #: J \ 9 (.,
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DEP~!MENT:
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ACCOUNTING
CODE ENFORCEMENT
PLANNING
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FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK ~
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
/ /
Date Applicant Contacted:
Date FOIL fulfilled or denied: / /
Closed by:
(JJA '18.
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Date:
Notes:
Amount Due:
Pages for a total of $
Name: ~.~ ~fI{f2IJJl"
Address: 'c,' J-.I(~ ) V€J
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Agency or firm: S e 1.1?-
Telephone #: ( tg'i() (iBL- 7 t./ I () FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPE,C, lFI~, ~ESCRlPTION OF RE=a&' (/(J-e-15 C'A4-- cuzd ~)
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~X P E Jl/ S E c 0 NT ~ 0 1- 11 E f' 0 Ie l' r R R. V E";N tJ.. E C 0 NrA (J L
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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-maiJ to the address listed above
o I request that the records be faxed to the number listed above