245
Received by:
Chris Masterson 0
Christine Fulton 0
Su~ Rose . .~
LI/LIJL
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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. #:
DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
4-1 ~ ILL
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(init)
Date Applicant Contacted:
I I
Date FOIL fulfilled or denied: ~ I d- I 1L
Closed by:
fJ IZir
.!ll ~/..lL
Date:
Notes:
Amount Due: A- Pages for a total of $ I. eJO
Name:' \..~V\(\. ~~Rt\-~ S 0 check here if you are
Address: ::;).~ \"h-, II \~1 K... J-r~ _ requesting that the records
V{"~ ~ n~ toR ~ K.... tts ,-....It (2-5'9,-, be mailed to this address.
Agency or firm: ,)
Telephone #: (tt.lS ) l51L- J-.'i"i 1 FAX #: (
Email addresS:fktL~.<..ru. t ~ L oJ....~t' . (t
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
~ 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