071
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 ~
S~ROS~ 0
Date Received: _/ L/.!.L
FOIL Ser. #: -11
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES ~
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEP ARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
--
-
(init)
Date Applicant Contacted: - / - / -
Date FOIL fulfilled or denied: J & lL
Closed by:
Date:
/ /
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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.
FAX#: (trerJ tJ-Is: ~{~
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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