036
Date Received:
Chris MastersonS
Christine Fulton ~
~ue Rose 0
lE2. / at/I dOlO
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 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOIL Ser. #: ~UJ
FOR DEPARTMENT USE ONLY
Date Received by Dept 3 I ~ I 10
Department Head approval: - ,qc;-
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Date Applicant Contacted: ~ I L I I ()
Date F~~ denied: 3-J 1- /! 0
Closed bY~'-- III. ~~
Date: 3 111 (6
Notes:
Pages for a total of $
Amount Due:
Name:
Address:
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o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
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I request to be notified when I can come to inspect the record( s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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