174
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ""i
S* Ross;, D 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:
Oi ~APPI
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Date Received:
DEPARTMENT:
AS
ACCOUNTING
CODE ENFORCE
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK V
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept .!.-I ~~
Department Head approval: ~
(init)
Date Applicant Contacted: L / ~ / ~
Date FOIL fulfilled or denied: ~ / C / , t)
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Date:
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Closed by:
Notes:
Pages for a total of $
Amount Due:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (NdJ ..J9L,riIf... FAX #: ( )--
Email address: Be J.} f)1 ~ . <!. tfr/n AI J. , C. tJ J1L,
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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