231
Received by:
Chris Masterson 0
Christine Fulton ]
Sue Rose -,n/
&1/3 I~ 0'
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public, Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
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. Date Received:
DEP ARTMENT:
ASSESSOR ft
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY J
RECEIVER OF TAXES CJ
RECREATION 0
SUPERVISOR ]
TOWN CLERK ]
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER [J
TOWN ATTORNEY CJ
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
1 /
Date Applicant Contacted:
(init)
/ /
---
Date FOIL fulfilled or denied:
---
/
/
Closed by:
Date:
---
/
/
Notes:
Pages for a total of $
Amount Due:
"
Name: i
Address:
'C--
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (0 V\9)
Email address: \
SPECIFIC DESCRIPTION OF RECORD: d (
r:o~ ri(..t~_[~ IfrT'
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 nwnber listed above