181
Date Received:
Chris Masterson 0
Christine Fulton 0
S)l;.e Rose !f
XLI)21 lsL
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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:
FOIL Ser. #:
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DEPARTMENT: \:2
ASSESSOR ~'
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CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 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 Depl :i{ I ff--Jf:;
Department Head approval: "
Date Applic~tSontacted: g I 01 I Ii
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Date F~~~ fulfill~ or denied: .:E..'! / 7 I I 0
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Closed by: ,\' l^ J '
Date: 11111 (0
NOles: ~
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Amount Due: ages for Jtotal of $ ;;1 ~ q
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o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#:(fj(1~?/3~s FAX#: ( )_-
Email address: ~' cJ~ '} (fVI,DI-~//,. ctJ-?
SPECIFIC DESCRIPTION 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