304
Received by:
Chris Masterson 0
Christine Fulton []
Sue Rose ~
1L / (2;)/ J..L
(~6 <f
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIG~AY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 'j'i
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Date Received:
FOIL Ser. #:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date Applicant Contacted: _ / _ / _
Date FOleOr denied: // / 30/ 1L
Closed by: @
Date: fL / .22. / ~
Notes: UJ tl:&t~+-+.f::.-
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Amount Due: 3C~~g~s for a total of $ t 75
Name: Pr L..:f= tl. to \:) fl1"J1""1]J ~
Address: -:?n !M4~ ~~t7
fJu- ~ 110 L - - t:J
Agency or firm.: '~
Telephone#: O\a {"11~~ "l::l- FAX#: (~1.) (Jt - 661'$"'
Email address: AHMlf1RK.b~ Q r.t-
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD: IV o..L~,.J'; 1'" S4
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e: 4..~.A \4 4' ~ 1 ~ _____
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FORMAT OF RECORD (if available)
o I request to be notified when I can corne 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