228
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ]
Sue Rose '~
~/~/12- 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:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR []
HIGHWAY []
RECENER OF TAXES J
RECREATION 0
SUPERVISOR J
TOWN CLERK ]
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY J
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Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
It) / l.;l/ /0
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(init)
Date Applicant Contacted:
/t//IZ.//C
Date FOI lfilled or enied: / () / ("L/ / u
Closed by: tJ167
Date: I () / I z..... / / u
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (
Email address:
FAX #: (
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SPECIFIC DpSGRIPTIO~ Of ~9S>~:^ \ I
10 LA K<'- DV'vf tLd 12:E) yv I .. . J 261 0
FORMAT OF RECORD (if available)
)( 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