281
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ]
Sue Rose W
)~/&kt1L ..
c981 //
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING 0
FIRE INSPECTOR 0
HIGHWAY []
RECEIVER OF TAXES J
RECREATION 0
SUPERVISOR J
TOWN CLERK J
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY J
Date Received:
o
o
V
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/0 I .2P'1 .!!.-
34
(ini t)
Date Applicant Contacted: /0 I pZil !!-
Date Fo~r denied: ((/ / ? g I ~
Closed by:
Date: d~J-
Notes:
40
(o/z-?III
---
Pages for a total of $
Amount Due:
Name: ~,,\ J.. ~C{.;n III(..&>
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:Y~~ Dl"eJ - C) ~ II
Telephone #: (8i() C, ~).,.- Le ~OQ FAX #: (
Email address:
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SPECIFIC DESCRIPTION OF RECORD:
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~Y\ \- ~ ~\J.J..\I"'" ~ <!) (r. ~~. S~~~ .
FORMAT OF RECORD (if available)
1
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