154
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton p(
Sue Rose 0
Date Received: ~ /82/ ~
FOIL Ser. #: I 5 L-J_
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING ~
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
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:
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Date FOIL fulfilled or denied:
Closed by:
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Date:
Notes:
Amount Due: 0 Pages for a total of $
Name: 6~t 4d'
Address: 3 /" () tJI , tl tJ t-J IJ/. .
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Agency or firm:
Telephone #: (?;, ~ ) 'lli--/3 7'-1 FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPT)ON 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