072
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton 0
Sue Rose ~
Date Received: -:L I HI -LL
FOIL Ser. #: # -; Q
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~ /'
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECEIVER 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 J 1 111 LL
Department Head approval:
(init)
Date Applicant Contacted: 3 1 (~'I ((
Date FOIL fulfilled or denied: ~:IJ I (
Closed by:
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Date:
Notes:
-----
Pa~ror a total of $
Amount Due:
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or finn:
Telephone #: (fj S)
Email address:
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SPECIFIC DESCRlPTION OF ~co~:
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FORMAT OF RECORD (if available)
IJ 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