117
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton rri
Sue ROSr IIf\ 6
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Received by:
Date Received:
FOIL Ser. #: I ) 1
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERV
OWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
Name:
Address:
Agency or finn:
Telephone #: (
Email address:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
f2 /d-I / l!L
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Date Applicant Contacted: _ / _ / _
Date FOIL fulfilled or denied: :2 0-1 / 10
Closed by: @
/
/
Date:
Notes:
Amount Due:
o check here if you are
requesting that the records
be mailed to this address.
)--
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 1 request that the records be sent via e-mail to the address listed above
o 1 request that the records be faxed to the number listed above