108
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose \[?'
.b-I 21 (0 0
1fi ()~
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING Er'"
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK ~
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
POR DEPARTMENT USE ONLY
Date Received by Dept 01 / I () 1 I"
Department Head approval: - -ffl-
(init)
Date Applicant Contacted: () J 1 J!L / J!...
Date FOIL fulfilled or denied: () ( 1 !!!- / !!.-
Closed by:
f1'r
01/ ..J!!. 1 ~
Date:
Notes:
Amount Due: _ Pages for a total of $
Name'
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or finn:
Telephone #: (3lfC )2:f1:l..2'I../Q FAX #: ( ) -.
Email address: B(!.f) rn e-AI d~ (cL G.. fhlJ 1'- I '-CJtI'l./
S~Dl'~~/O~~:CrM~~ ~~
FORMAT OF RECORD (if available)
o I request to be notified when 1 can come 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