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156
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
Chris Masterson g,
Christine Fulton ~
Sue Rose 0
2kZY~
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Date Received:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT %
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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_ .l'JFOR DEPARTMENT ~SE ONLY
e Received by Dept .:. / ,l Si //
Department Head approval: - ~
(init)
Date Applicant Contacted: .i;L / 0 I /..!..L-
Date FO&or denied: ./12...1 P...L / g
Closed by: ~ 0:-
Date:
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Notes:
Amount Due:
Pages for a total of S
Name: t3 Ci.r ho. orA G' LA. + 2. I e'.r
Address: S tu s, e t- 1- tt"" e-
Wtiff; YI~ eI\ re;.,t/s ,NY /~J-tjtJ
Agency or firm: -
Telephone #: ( &j I Lf ) '7$'9 - L( ~/() FAX #: (~4J)~-
Email address:bo.rbQiJ+~/er@o./Y\tJl.i t. C4W1
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
f2.. e CC'C' d s .f3o..r -M e. CA s ~ f-I1.-e tJ' /Vtt;.. O'~ h "iA S ~ 1.."""" U': Icl tV" ~d ri ve. '.
-()(i,':J'/lA ( build,'nj per-mi-f tt/l\d. Cln~ ';l.(]Y\;"'j te.rm ;f;, &r vt1r,'~Ce5
- Ori 5'/1~1 ~/YIfla,i"f A-let! o.~'(~//I~'" frcftl-r1J r:rw/J'l'~ ef41d resulT
- a tI tJlffc-rn{/s bd/s ~nd C-t'urt ~ee5 ~e.,VI -fc -+t..tL ~1l
-a./ tt -j-+z,Y'1'l e I) ,'lis and ~t(rte es Cl id" f:n,vn.
FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the record(s) described above
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
1 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
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