243
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose JV
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Received by:
Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
it:) / .J11 10
-~
Date Applicant Contacted: Lf2 1 ;/91 / 0
Date F~fi~enied: I c:; I?J... / / 0
Closed by: f( (i.-
Date:
/OI"ZCjI/O
Notes:
Amount Due:
Pages for a total of$
SPECIFIC DESCRIPTION OF RECORD:
Name:
Address: I
requesting that the records
be mailed to this address.
~
Agency or firm: ~ / .
Telephone #: 11'/) ..&-
Email address:
FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record( s) described above
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 thatthe records be faxed to the number listed above