266
FOR ~Rl'!AL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton ~
tue Rose 0
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Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
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ZONING '0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Puplic Ac~e.ss to Records
FOIL REQ,UEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept .& / (;;{ol
Department Head approval:
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Date Applicant Contacted: to / 1'1/ U--
Date FOlL fulfilled or denied: .&...1 .LZ / LL
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Closed by: <tV
Date: .i2../ a/ YI-
NoteS: M m(}(cM ,(\ fJblllllll1
Amount Due: _ Pages for a total of$
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o cbeck,here if you are
requesting that the records
be mailed to this address.
Name: 50 ~ ,,' l'1l~I.H'I).fb\
Address: .J} ~~ g (\" ~ \)
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Agency or fum:= 'Jv C Au.:'-t1 - fLu) ?:<.h..U - =
TelopboDe #: (ql'-{l :t!Ll: a..o~ I FAX II: (S'i, ) ~- 'I 77Lf
Email address: ::ro I; \r~~I'C1 C;; k ou I i l\M l-o..lWren c.l' . '? rn
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
~ I request to be notified whon I can come to inspeCt the record(s) desCI1Ded above
o 1 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
8"../ I request that the teeords be sent via e-1D8ll to the address listed above
W 1 request that the records be faxed to the number listed above