234
FOIL Ser: #:
Chris MaSterson &
Christine Fulton ~
J ~ ~s5 /d'\} to 0
c961
2009-10-16 JCM
TOWN OF WAPPINGER
Appli~ation for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER )t
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept w.. ~if' 6
Department Head approval:
(mit
Date Applicant Contacted: / /
Date:
/
Date FOIL fulfilled or denied: /
Closed by:
Amount Due: _ Pages for a total of
Notes:
Name:
-Address:
o check here if you are
--requesting-that-the-records---
be mailed to this address.
JIC DESCRIPTI~F RE~ I~~-- f'~ , U j ~ ^ ll<'
1 ()ol..elt .' . \...;c{~-t1-T rfn (LV>
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