109
FOIL Ser. #:
Chris Masterson
Christine Fulton D
Sue Rose D
5-1 hi tU
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0/
CODE ENFORCEMENT [jf
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept .5' I & I /0
Department Head approval: u~
(iilit)
Date Applicant Contacted: ..5' II -3 I / 0
Date FOIL ~ or denied: .51 13 I / 6
Closed by: 1/ sl/c:vt..
Date: ~I t.:J.I /0
Notes:
Pages for a total of $
Amount Due:
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: &4~) ~~~_-~ FAX#: (8
Email address: -m . fl.U'l~nYUd '
) ~- 632>1
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SPECIFIC DESCRIPTION OF RECORD: I _ '\
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FORMAT OF RECORD (if available)
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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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