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FAX NO. :2274291
Jul. 29 2010 12:52PM P1
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FOIL Ser. #:
Chris Masterson 0
Christine Fulton ~
Sue Rose 0
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155
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR
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Date Received:
CODE ENFORCEMENT
PLANNING
ZONING ~
FIRE INSPECTOR ~
IDGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR ..~
TOWN CLERK '0' .
WATER/SEWER 'if
DOG CONTROL OFFICER 0/
TOWN ENGINEER 'E1
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONt y
Date Received by Dept ~ 1 Zfl..1 ( D
Deparbnent Head approval: _
, I (init)
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. Date Applicant Contacted: :1. / a / 12-
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Date F<;nL fulfillesYor denied: ~ l;;l 1 /0
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Closed by: )j 6-
Date: !l./ 2.1 /0
Notes:
Pages for a total of S
Amount Due:
Name:
Address:
o check here if you are
requesting that the records
\2fB3 be mailed to this address.
FORMAT OF RECORD (if available)
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1 request to be notified wben 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
1 request that the records be sent via e-mail to the address listed above
I request that the records be faxed to tbe number listed above
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