206
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton ~
Sue Rose ~
Date Received: 3- / J.l2.. 1 l..Q.
FOIL Ser. #:
c90 ~ +- /)(16
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING cY'"
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK [j./
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
1-/JJ)~
1:ir
(init)
i/l1./~
Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: L I' \ 1 ~
Date:
-5---1f
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Closed by:
Notes:
Pages for a total of $
Amount Due:
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Name: } , Z-
Address: __~_ ~e l'~ i V~~t;90
Agency or firm: S ~
Telephone #: (?J5) ~- 7 '-II 0 FAX #: (, ) _-
Email address:aJ1eJ1@.i/. t) '1'C
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF R;gCORD:
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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