009
FOIL Ser. #:
Chris Masterson 0
Christine .Fulton ~
~e Rose ~
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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 H
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 Depl . 1- I ~W .
Department Head approval: G- ~I{
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Date Applicant Contacted: L I n I /0
Date FOIL fulfilled or8: L' Z]' LP-
Closed by: -S. I(o~ b'JL 0
Date: .1-1 ;/71 /0
Notes:
Amount Due: _ Pages for a total of $
Name: ~ / tYI ~ /l A... L () '\ ct t- /
Address: 7 '4.e.~ 1(\ L ~'" l..
I\J(>J.J PI';.{ft: IIi IzSt.1
Agency or firm: X l.c
Telephone#:(91~f)~.t)lIS FAX#: ( ,)- .-
Email address:~CoOyt..vl\a..t;(?.At () L . C i) n-,
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:r'
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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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