264
FOIL Ser. #:
Chris Masterson 0
Christine Fulton ~
Sue Rose 0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application 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
HIGHWAY J
RECEIVER OF TAXES Q
RECREATION 0
SUPERVISOR ~'
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY []
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Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date Applicant Contacted:
/ /
Closed by:
Date FOIL fulfilled or denied:
Date:
/
/
Notes: 7Y"O../Ick6. doeu(Y).fo<yt- d.. \'"a::..t-'
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Amount Due: Pages for a total of $ ,,'75
FAX #: (
o check here if you are
requesting that the records
~mailed to this address.
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Name:
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 that the records be faxed to the number listed above