094
Date Received:
Chris Masterson
Christine Fulton
Sue Rose
1- / a:!:L / 12-
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING %
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEP ARTMENT USE ONLY
Date Applicant Contacted:
L/1.-3 I~
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(init)
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Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: L / t.-~ I ~
Closed by:
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Date:
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Notes:
Amount Due: _ Pages for a total of $
Name: I
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm: .
Telephone #: CS1n ~- .
Email address:
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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 1 request that the records be faxed to the number listed above