031
Received by:
Chris Masterson 0
Christine Fulton ~D
Sue Rose .
3-/L/R
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 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
Date Received:
FOIL Ser. #: ;;/f: ;/
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
0$10/110
~
Date Applicant Contacted: 0.3 10 I 1 LQ
Date FOIL fulfilled or denied: q2 1 tJ ( 1 I 0
H~
Closed by:
Date: r ) .2 / 0 ( / I b
Notes:~ Q~i ~i
Pages for a total of$
Amount Due:
Agency or firm.:
Telephone #: ( go-
Email address:
o check here if you are
requesting that the records
533 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
~ I request that the records be faxed to the number listed above