119
Received by:
Chris Masterson 0
Christine Fulton' )
~e8W/JO 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 'IJ
ACCOUNTING 0
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
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ .!f;c!Jtl/ 0
Department Head approval: _
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied:
/
/
Closed by:
lJzJ
Date:
/
/
Notes:
ages for a total of $
Amount Due:
Name: .s fL,r4-n *..f/~
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:)h, ul; h ~ L4fA- JriYnc rp
Telephone#: (J>.y))~- 31'3" FAX#: ( )_-
Email address:
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
o I request that the records be faxed to the number listed above