128
Received by:
Chris Masterson
Christine Fulton
Sue Rose ~
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REOUEST
FOR INTERNAL USE ONL Y
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREA TION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER ~
TOWN ENGINEER !
TOWN A TIORNEY :....~
n
FOR DEPARTMENT USE ONLY
Date Received by Dept 1/ Jc, /1
--~
Department Head approval: __~_
(in it)
Date Applicant Contacted: ~ 1-1 L
r denied: ~" / -1-. / -'L_
Closed by:
t1I(;"
:)/ 51 II
Date:
Notes:
~ It,
Amount Due:.~ Pages for a total 01'$
Name: ~f~ ~~~/1~
Address: 3 (!JJ't : ,)C)ocf _ "
/1.)JjJ;.'k'p~r><ie _ /lJ X /.).6()5,
Agency or firm: 5e1 ~
Telephone #; (<i'YS-).YZL- 't ?70 FAX #: ( )_-
Email address: J~ OSr.:N 11 "1/ e-- qot.. ,C 0 I\A.
1 check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
Pj;ot-,o (!Of>-J () f- ;-=/001' Plt<.n 0 f ;Dro/?er 1-1 CA..r
~"D' -L.3..S..-~fi.~ - ~~s:'; .- 0 ~- .;? ~~ 7 <j.< - C) OOn
'tIrfPS5: 3'1'7 Ce ", /1 d
--&~el?1eJ'lj-- " / 5/',.,.c-/r .;J net Fir
FORMAT OF RECORD (if available)
9:< y"
I request to be notified when I can corne to inspect the record(s) described above
Y 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
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