244-245
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton ]
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
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WATEWSEWER 0
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TOWN ENGINEER [J
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: !I- I -
Closed by: .l
/1
Date:
l.L / 1- / J...SL
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
a.
Agency or firm: , ~ e. J:;'
Telephone #: ( Hi") ~~ -,1//(:) FAX #: ( ) --
Email address:BCRmEr?rlice..<;emfJll.-..c.o m.,
SPECIFIC DESCRIPTION OF RECORD: ,
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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