052
Date Received:
Chris Masterson 0
Christine Fulton 0
Sue Rose '~
3- I Lk I .J..Q
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~_
CODE ENFORCEMENT 8
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECENER 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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FOIL Ser. #: 15 r9
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
~I llJ 12-
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Date Applicant Contacted: .l. I ~-4 10
Date FOIL fulfilled or denied: ..J- / Jt:1 &.
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3.. / r1! / LJ2
Closed by:
Date:
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
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o check here if you are
requesting that the records
be mailed to this address.
FAX #: (
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SPECIFIC DES~RIPTION OF RECORD:
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FORMAT OF RECORD (if available)
)( 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
o I request that the records be faxed to the number listed above