036
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Date Received:
Chris Masterson 0
Christine Fulton .
Sue Rose 0
0d-/150011
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #: 3Lo
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DEPARTMENT:
ASSESSOR if
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 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
Department Head approval:
/ /
(init)
Date Applicant ContacRECEnIED- il--
Date FOIL fulfilled or ~: 5..l.On_ / _
Closed by:
mWN OF W
"'SESSOR's OFFJa
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Date:
Notes:
Amount Due: ~Pages for a total of$ I
Name: prl-o L ( () l ( (1/ r./ sic (
Address: ~e. jJ 1
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Agency or firm:
Telephone#: ~V~ )7B3-- 01/11 FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTIQN O~ftECORD:
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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
~ 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