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149
Received by:
Chris Masterson 0
Christine Fulton ~
~e Rose 0
~ -L /Z;;i &
;L/Cf
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
ASSESSOR
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 'Q"
FIRE INSPECTOR i:j"\
HIGHWAY 0
RECEIVER OF TAXES ~
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
Date Received:
FOIL Ser. #:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
~/~/llL
~
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied:
/
/
Closed by:
t-JrUr
~/~/I.E-
Date:
Notes:
Amount Due: --J,.lPages for a total of$ 3./ <)
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #:
Email address:
SPECIFIC DESCRIPTION OF RECORD:
eJMM\~ -~JtZJ~~3l ~
-- '3~ '11 :l
- >?1 }~
FORMAT OF RECORD (if available)
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
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
