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179
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 1>f
~~ Rose 0
U.QI /31 J.D.
1-1 q
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
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Date Received:
DEPARTMENT:
BSSOR
ACCO
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECENER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
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Date Applicant Contacted:
1161111(1)
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(init)
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Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: ,? I..!...- / ~ .
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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.
FAX #: (
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S~CJFlC DE~CRlPTION OF )YlCORD: , t A
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B ills C!t~J ~.OV'f'€5f()HJe;lc e
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
