058
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEP ARTMENT USE ONLY
,
Date Received by Dept 8 / 15/ I 0
Department Head approval: ~
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Date Applicant Contacted: ,
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FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose \y
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Date Received:
RECENEO
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
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PLANNING
ZONING 0
FIRE INSPECTOR .J>< .
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
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Date FO! fulfill or denied: / /
Closed by: ,J ~
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Date: Jj;} .do r:3," .J,' f 1
Notes: f;H wfJ..-?- fW' {FJ ;:
Amount Duet ~ p:'. for. total Of$~:r. ~~
1\7 check here if you are
v ~sting that the records
be mailed to this address.
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tJh11[141 h.$. ,NY lo6()L/
Agency or firm: en
Telephone #: (~ I tj ) ~- 4 7-/LI FAX #: (1/ ~ ) J.J.!L- ~ "1l.{l(
Ernail address:
Name:
Address:
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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
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
)8( I request that the records be faxed to the number listed above