076
Received by:
Chris Masterson 0
Christine Fulton ~
Sue Rose 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
DEPARTMENT:
ASSESSOR
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0 c, \) ~6~
FIRE INSPECTOR \\~~.. ss~sS4
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RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
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Date Received:
FOIL Ser. #:
FOR DEPARTMENT USE ONLY
Date Received by Dept .::L / 5 / ~J U
Department Head approval:
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: d / ~ / itQ ~ ()
Closed by: ~
Date:
/
/
Name:
Address:
Notes:
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Amount Due: ~ Pages for a total of$ 6' U
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #:
Email address:
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SP~IC DESCRIPTION OF~?f: rh..t
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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
rzr 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