175
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ""i
S~ROSh '0 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:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERV OR
TO CLERK ro/
WATER/SEWER
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Date Received:
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
V<( / cA / IU
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(init)
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Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: / /
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Closed by:
Date:
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 #: (N~ .-J9Li&... FAX #: ( )--
Email address:-BC '" ~ . ~ tttn AI J,. I C eJ Ii.
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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