022
Date Received:
Chris Masterson 0
Christine Fulton g/
Sue Rose 0
02-. /rLl / (}!2j D
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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 ~
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 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
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FOIL Ser. #:
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
1.. / " / /0
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(init)
2/~/-LQ
Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: '2 / ~ / ~
Closed by:
Date:
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Notes:
Amount Due: Pages for a total of $
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Agency or firm:
J,tlf7..... Telephone#: rJq.~).ML- q6~ FAX#: ( )--
7 'It) Email address:
o check here if you are
requesting that the records
be mailed to this address.
FORMAT OF RECORD (if available)
~ 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