167
FOR INTERNAL USE ONl Y
2009-' 0-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REOUEST
Received by: Chris Masterson
Christine Fulton i
Sue Rose Y
Date Received: 1L 1 !L 1 /1
Fall Ser. #:11 167
DEPARTMENT:
ASSESSOR
ACCOUNTING _ ~
CODE ENFORCEMENT ~
PLANNING
ZONING
FIRE INSPECTOR ~
HIGHWAY
RECEIVER OF TAXES i 1
RECREA TlON
SUPERVISOR 'fP
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER I
TOWN ENGINEER
TOWN ATTORNEY ! I
FOR DEPARTMENT USE ONL Y
Date Received by Dept 6- !~. . .
Department Head approval: tf!!!:{-
(a 12/JJ
Closed bY:rx II ^ J-
Date: ~
Notes:
Date Applicant Contacted:
Date FOIL ulfilled or enied: ~ / 9 /1L-
UU-
Jz/ 1/ II
Amount Due:
Pages for a total of $
Name: r~J) . /fA~ t?Y/.ptl~r/
Address: (,I .t{,'p'.rJ/~k~./ I.- ,l-J.
~/~ ~~ ! ~'( /2::)fo
Agency or fin . I rt'htW .e.... ~ IoiA..-I/1?t. c:e
Telephone #: ('1/7 ).n.L- ~ z..t L FAX #: ( )__
Email address:-r-01;)l::>t-.\.c......tZQ.--r-.CANS.-A-re-.c.oM..
J check here if you arc
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
,4,..., tf+.~ ,4.-t( Ill~pr l....-t =- d: (:.loor (7\,q,J ~ ( c.. ~ .J.o ~ 7;w,(/ ".I W'1-?~"A.f :'3
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t.+l\J ' ~. I Uf o.
FORMAT OF RECORD (if available)
I request to be notified \-vhen 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
I request that the records be sent via e-mail to the address listed above
I request that the records be laxed to the number listed above