097
Received by:
Chris Masterson 0
Christine Fulton 'i1
S>>e 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
FOIL Ser. #:
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Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT )(
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
1_.1 LL I iL
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Date Applicant Contacted: .i.. I lL I f.L-
DateFO~denied: !:II If 11/
Closed by: II tj
Date: \ 'J) ~ 1) ( .i /10 ..!.L
Notes: ~ v
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: ( '\ I
Email address: ,^
SPECIFIC DJ':~TION OF RECORD: J_
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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