062
Received by:
Chris Masterson 0
Christine Fulton 0
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:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING ,~~
CODE ENFORCEMENT L::>
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN AITORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Depl '7 I ~
Department Head approval:
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Closed by:
Date:
Notes:
Amount Due:
Name: _ -r LA Ae ]) u Re. 0 check here if you are
Address: z- g -r 0 R ~ requesting that the records
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SPEC~IC DESCRIPTION OF RE~~: L~ 0fJ
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FORMAT OF RECORD (if available)
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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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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