109FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 0
Date Received: vw) 0 1 I -A -W tP
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
F1
CODE ENFORCEMENT
�e
PLANNING
El
ZONING
11
FIRE INSPECTOR
11
HIGHWAY
11
RECEIVER OF TAXES
0
RECREATION
1.1
SUPERVISOR
0
TOWN CLERK
WATER /SEW
DOG CONTROL OFFICER
D
TOWN ENGINEER
0
TOWN ATTORNEY
F1
2009-10-16 ,ICM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
g
FOR DEPARTMENT USE ONLY
Date Received by Dept Z/3
Department Head approval:
0
#Iil)
Date Applicant Contacted:
_V, / / & /2— -3
Date FOI ulfilled r denied,
Ulf
Closed by:
Date: 9
Notes:
Amount Due: _ Pages for a total of $
Name: —2a f \, n El check here if you are
Address: requesting that the records
A&Mina-S i>ACQ be mailed to this address.
Agency or firm:
Telephone #:
Email address: -2 FAX
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SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available) �o'l�
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
1 request that the records be faxed to the: number listed above