151
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton ')6
Sue Rose 0
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Received by:
Date Received.:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HI
OF TAXES
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
Name:
Address:
Agency or firm:
Telephone #:
Email address:
FOR DEPARTMENT USE ONLY
/ /
Date Received. by Dept
Department Head approval:
(init)
/ /
Date Applicant Contacted:
Date FOIL fulfilled. or denied:
/
/
Closed by:
Date:
/
/
Notes: '\:)(d "-\0+ ~ cJ
Amount Due:
Pages for a total of $
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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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