030
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
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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 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER 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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Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
2/J.b'/ /0
Date Applicant Contacted:
(init)
2../ JJ; /0
Date FOIL fulfilled or denied: J I OJ (; 10
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Closed by:
Date:
Noles: ///rf;~
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AmountDue:~esforatotalOf$ -~ 3/ -
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
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Agency or firm: '9, i
Telephone#: fqf) <9-q 7~ L/I (FAX#: (
Email address:
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SPECIFIC DESCRIPTION OF RECORD:
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