080
Received by:
Chris Masterson 0
Christine Fulton 'E(D
Sue Rose
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2009-]0-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ,0 /
CODE ENFORCEMENT ~
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 AITORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept 1 1 -.i 1 / 0
Department Head approval: -14;:-
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Date Applicant Contacted: -.1 1 1 1 / U
Date FOII(fui~~c:t~~enied: ,L( 1 l 1 I ()
Closed by: ----.- I-{ C-
Date:
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Notes:
Name:
Address:
Amount Due:
Pages for a total of $
check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: (fl/51 &sw- 4JLo'f- FAX#: ( -)_-
Email address:
SPECIFIC DESCRIPTlON OF RECORD:
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FORMAT OF RECORD (if available)
o 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
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