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038
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton 0
Sue Rose .~
3- / .!i / -Lil
#3~
Received by:
Date Received:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECENER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept !L / .3- / ~
Department Head approval:
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: /
Closed by:
Date:
3-/:L./LL
Notes:
Amount Due: _ Pages for a total of $
Nmne:~~~"li~~
Address: .. ... . . .<=>: / L ~y .
Agency or firm: ~ e.
Telephone #: ( S'I5'> aEl.L-7 '1J 0 FAX #: \ ) _-
Email address: 13 C-Jti mEAl G: 14- ~, a-m C\ /1 " Co 111-
o check here if you are
requesting that the records
be mailed to this address.
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
