164
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 0
Sue Rose ~
Date Received: ~ / l / J-'-.
FOIL Ser. #: 1t/& t-{
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DEPARTMENT: ~
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT 0
PLANNING 0
ZONING 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 ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: _I ---: ~
Closed by: RECEIVED ~
Date: JUN 8 7 2011 / /
--
TOWN OF WAPPINGER
Notes: ,
Amount Due:
Name: A/1; M ()CL-
Address: :3 J t::::> 1\..15 y J...A-tI. t!-
oJ (\fl () I Yl r .Q"..ll ~ AJ" p... S'c:; ()
Agency or firm:
Telephone#: (tL{() @J)... - :>,,(,7 FAX#: ( )_-
Email address:
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OE"RECORD:('"\ Do~ _ C /. / J
(~py Or ~eJ ~ ~ - LQ Un &~
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