161
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 ~
Sue Rose 0
Date Received: I.L / 2 / .:::x:> (I
FOIL Ser. #: 1lJ11
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DEPARTMENT: }..(
ASSESSOR ~
ACCOUNTmG 0
CODE ENFORCEMENT 0
PLANNmG 0
ZONmG 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied:
3:>1::1::10 S,~OSS3SS\1
Clo.dd\1M ::10 NMO.L
Date: HOtfO Nnr
Notes:~~
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L&3
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Amount Due:
Pages for a total of $
Name: rn A R-l 'SOL G\J In Of] e~ 0 check here if you are
Address: ~~~ ~~\:; requesting that the records
- V\f1 l I tJ (2'Y1o be mailed to this address.
Agency or firm:
Telephone #: ~ ~<3) ~-02.-lf l-- FAX #: ( ) -
Email address:lfY1rY.lQJ-~@Va...r\2..cnll.( ~r
SPECIFIC DESCR~ON O~CORD:
C OPLi CP
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-mail to the address listed above
o I request that the records be faxed to the number listed above