310
FOR INTERNAL USE ONLY
Received by: Chris Masterson 0
Christine Fulton , ~/
Sue Rose 'Y
Date Received: J.d / I...:i. / -1L
FOIL Ser. #: /~I 0
DEPARTMENT:
ASSESSOR ff
ACCOUNTING 0
CODE ENFORCEMENT 0' - 31 ()
PLANNING 0
ZONING [J
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES r1
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
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Name: . ,
Address:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept /2. / .!!L / 1L
Department Head approval: ~Jt:...
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Date Applicant Contacted: f Z, / 1..!i / L!-
Date Fo~r denied: / 2.. /!!:L I i.!-
Closed by: If 6-
Date: d~"L 1_1..l(!Li ((
Notes:
Amount Due:
Pages for a total of $
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm: +fl5 (~( ;hlA1 l~fVn c,-e:-
Telephone #: CfY5'1.t:l.L- ? r:; G FAX #: ( )--
Email address:
SPECIFIC DESCRIPTION OF ~CORD: j. . ./ 11 j
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FORMAT OF RECORD (if available)
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
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
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