210
Date Received:
Chris Masterson 0
Christine Fulton 9?
~e Rose 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:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING ftt
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENEROFTAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ /:J.. 0 / /0
Department Head approval:
(init)
Date Applicant Contacted: _ / _ / _
Date FOIL fulfilled or denied: DC{ Bb/ lO
Closed by:
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Date:
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Notes:
Name: C tV
Address: 0
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Agency or finn: '
Telephone #: (~:'I S)c2!1l- ~ r:;/j,
Email address:
Amount Due:
Pages for a total of $ Q. ~ .
o check here if you are
requesting that the records
be mailed to this address.
SPECIF~. DES~RIPTIO~ OF REC,!;: ~ 1.It.
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FORMAT OF RECORD (if available)
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I request to be notified when I can come to inspect the record(s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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