176
Received by;
Chris Masterson 0
Christine Fulton 0
Sue Rose 8-'
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0 FOR DEP ARTMENT USE ONLY
ACCOUNTING
ODE ENFORCEMENT -}=j (If( Date Received by Dept / /
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PLANNING Department Head approval:
ZONING ~, /11 (init)
FIRE INSPECTOR 0 Date Applicant Contacted: /
HIGHWAY 0 /
---
RECEIVER OF TAXES 0 Date FOIL fulfilled or denied: / /
RECREATION 0 ---
SUPERVISOR 0 Closed by:
TOWN CLERK 0
WATER/SEWER 0 Date: / /
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DOG CONTROL OFFICER 0 Notes:
TOWN ENGINEER 0
TOWN ATTORNEY 0 Amount Due: Pages for a total of $
Name: I.{ ~V,'N' f-A/ 1?1J~
Address: 1: N~:; .~'~~
Agency or firm: / t" rA'"f, {;
Tel~hone #: (8L/J'li!3::- {/()'10 FAX #: (8LfF).JlL.-
Email address: e......,' (J';.! u,~del'-/^(/-. -c;?//I/1
o check here if you are
requesting that the records
be mailed to this address.
1?-97
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
R 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