239
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine. Fulton ~
Sue Rose 0
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Received by:
Date Received:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
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DOG CONTROL OFFICER 0
TOWN ENGINEER [J
TOWN ATTORNEY ~
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FOR DEPARTMENT USE ONLY
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Date Received by Dept
Department Head approval:
(init)
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Date Applicant Contacted:
Date FOIL fulfilled or denied: -Irt-'-
Closed by: .A---
Date: I () I~ I 1.2-
Notes:
Amount Due:
Pages for a total of $
Name: US)J
Address: Q. blA(lf
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Agency or firm:
Telephone #: (wr) 1:B..:l- CfrJ9'--- FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OlCORD: ~~ f. r;./ 'i i
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FORMAT OF RECORD (if available)
o Jrequest to be notified when I can come to inspect the record( s) described above
V- 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