049
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton ~
Sue Rose 0
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Received by:
Date Received:
FOIL Ser. #: -40,
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
OWN CLERK
WATERlSE R 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONLY
/ /
Date Received by Dept
Department Head approval:
--
(OOt)
Date Applicant Contacted: - / - / -
Date FO~ denied:> I 1/ I .!.L
Closed by:
Date:
.?;~.I'L / LL
Notes:
Amount Due: _ Pages for a total of $
NBI11e:. ~!/I;P~~l-.
Address: ,~l /) J V€J
: tUlh
Agency or firm: S e I R-
Telephone#: (tg'~()'d:lL-71./1() FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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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