207
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose e-
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#-80"7
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
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DEPARTMENT: ~
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEP ARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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(init)
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Date Applicant Contacted:
Date FOIL fulfilled or denied: -1t / L / .LL-
Closed by:
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Date:
Notes:
Amount Due: <g Pages for a total of $ ~ - 0 ()
Name: Lcrr::h...)~ ~l:?U'\}..j 0 check here if you are
Address: Z (P(( ~v.j V I Ue- /2 ~ requesting that the records
I-tJlJ Glr/2~ ~"C Wf"l fl ./ ?",.? be l!!.ailed to this address.
Agency or firm: ~L'R ~. ~Hv "'-..1 -S1 tr- 1'8-.% ~
Telephone #: ( t LfJ.) ~ J g, ? FAX #: ( ) _-
Email address: Le- ;..J'drls.I0rU €Z f} ,0 y.,,,, (,.'v': ..."v rcr
SPECIFIC DESCRIPTION OF RECORD:
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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
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