152
Date Received:
Chris Masterson 0
Christine Fulton ~
Sue Rose 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATEWSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept ()7 / cY ~ ()
Department Head approval:
(init)
Date Applicant Contacted: ()l /;) -; / /0
Date FOIL fulfilled or denied: () 7/ d/ /16
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Closed by:
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Date:
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Notes:
Amount Due: 13- Pages for a total of $.z;. / 5
Name: i
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or finn:
Telephone#:1Y )!:f!L-~. FAX#: ( )_-
Email address: ~~ u"Jj S'O/v5.,Tz. , (.o/lr)
SPECIFJC: DESCRIP~ON ,OF RECORD:
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FORMAT OF RECORD (if available)
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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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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