219
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REOUEST
Received by: Chris Masterson
Christine Fulton ~. 1,.
Sue Rose 61
Date Received: XI LI ~
FOIL Ser. #: 17dl 7
DEPARTMENT:
ASSESSOR [J
ACCOUNTING
CODE ENFORCEMENT ]X
PLANNING IJ
ZONING []
FIRE INSPECTOR [J
HIGHWAY D
RECEIVER OF TAXES D
RECREA TION []
SUPERVISOR Ii
TOWN CLERK [J
WA TERISEWER IJ
DOG CONTROL OFFICER U
TOWN ENGINEER U
TOWN ATTORNEY []
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
fJI911t
~
(init)
Date FO
denied:
LIL/~
'J / ? I tt
--
1f6
7 I 9 lIt
Date Applicant Contacted:
Closed by:
Date:
Notes:
Amount Due:
Pages for a total of $
Name: Michael C. & Annette R. Schrenkel
Address: 25 Chelsea Road PO Box 140
Chelsea, NY 12512-0140
Agency or firm: SELF
Telephone #: ( 845 ) ~- 1941 FAX #: (
Email address:schrenkel@aol.com
check here if you are
requesting that the records
be mailed to this address.
) -
SPECIFIC DESCRIPTION OF RECORD: Any and all documentation related to the above named
person(s) and property held by the department checked above. Including, but not limited to notices,
correspondence, memos, reports, records of surveillance and/or visits, photographic images captured
during those visits, notes made during those visits, and any other documentation pertaining to alleged
code violations at the above address.
FORMAT OF RECORD (if available)
r request to be notified when 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
X I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above