117
Received by:
Chris Masterson
Christine Fulton
Sue Rose
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
RECEIVED
APR 182011
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FOIL Ser. #:
TI~WN OF WAPPINGER
SSESSOR'S OFFICE
DEPARTMENT:
ASSESSOR "'-...Q
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERV1S0R 0
TOWN CLERK. J
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: / /
Closed by:
~
Date:
/ /
Notes:
Amount Due: d Pages for a total of $ I, ~ a
Name: ....:-~...'~~,~ ~"S. ~
Address:~~ ~ ~
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Agency or firm: J
Telephone#:~~~)~-~\~ FAX#: ( )_-
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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