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FOR INTERNAL USE ONLY
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Received by:
Date Received:
FOIL Ser. #:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY ~
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
1 1
Date Applicant Contacted:
(init)
1 1
Date FOIL fulfilled or denied: ---+/1 _ 1 _
Closed by: Jf
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Date:
12-p-J- 1/2-
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
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Agency or firm:
Telephone #: (ftV ~- 9.1' t:l FAX #: (
Email address:
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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
o I request that the records be faxed to the number listed above