140
Received by:
Chris Masterson 0
Christine Fulton 'ri
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
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RECEIVED
JUL 0 92010
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT .~
PLANNING ~
ZONING ~
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
BUILDING DEPARTMENT
TOWN OF WAPPINGER
FOR DEPARTMENT USE ONLY
212../ /0
~
(init)
Date Applicant COJ~cted: -2-1 / if; /0
Date F L fulfil;~ 0 denied: :.1 1 / r// 0
Date Received by Dept
Department Head approval:
Date:
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1107
.:]1 lJJl 0
Closed by:
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
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tl -r-Bl ~. Perf'YV1.t:r
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