169
FOR INTERNAL USE ONLY
2009-] 0-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by; Chris Masterson 0
Christine Fulton ~D
Sue Rose
--
Date Received: lL / 10/-.l.L
FOIL Ser. #:
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DEPARTMENT:
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ASSESSOR ~
ACCOUNTmG 0
CODE ENFORCEMENT 0
PLANNmG . 0
ZONING 0
FIRE mSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGmEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
J.L/ 10::- / ~
~'
(init)
/ /
---
Date Applicant Contacted:
Date FOIL fulfilled or denied: JL / is:.: / LL
Closed by:
10e.~
lL/li./ lL
Date:
Notes:
Amount Due: ....fL Pages for a total of $ t, 00
Name:5~.'r1~~ 7r.4c.ey'-8r~~
Address: f 0 b/,.-,So/? Cr~.I #--J
1.LJa!.tIf7/~I'~ ~aL/S' IVV/,;-SYO
Agency or firm;' /
Telephone #: (3y'l) 2.2 h - bJ- S-7 FAX #: ( ) __
Email address:j.Av?-.?...-e#n(.ne
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
Ar'~d
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