050
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton 0
Sue Rose 0
Date Received: / /
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FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODEENFORCEMlliNT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES ~
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept 3- / 1!E / ;)01 0
Department Head approval: C'~
(init)
Date Applicant Contacted:
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Date FOIL fulfilled or denied: ..l / I" / ~ (!) J~~
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Closed by:
Date:
3-/ JJ:/ J6/0
Notes:
Amount Due: ~ Pages for a total of $ ,SO
Name:
Address:
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o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION 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
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