211
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #: f}..ll
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 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 Dept 'I / ;J ;t / / U
Department Head approval: "7: P--
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Date Applicant Contacted: ..L../ A '! / ~
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Date F~;..;Jjil\ed ~ed: 1-1 ~ 'Z II 0
Closed by: ....-- t/ 7
Date: /(): 0 (j II. '1. .1_) ,;/9/ /0
Name:
Address:
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o check here if you are
requesting that the records
be mailed to this address.
Agency or firm: h/II.-/)tvo 0/) 1/AA-/IIiJA. ~,Nj {) ASf 0 C-
D~~-Telephone#:(s'f))~- 4t5)'/ FAX#: (Cl{j)SVt- - tl,flJ-/
Email address:
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
I 0 I request that the records be faxed to the number listed above