153 (2)
Received by:
Chris Masterson 0
Christine Fulton ~
Sue Rose 0
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. . \J I ., 2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR INTERNAL USE ONLY
Date Received:
FOIL Ser. #:
DEPARTMENT: -r
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT )
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK iJ
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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(init)
Date Applicant Contacted: g/d-& {O
Date FOIL fulfilled or denied: ~ ~ I (0
Closed by: ~
Date: .s--/~/.J.O
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Amount Due:
Pages for a total of$
Name:
Address:
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o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (
Email address:
FAX #: (
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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