027
Date Received:
Chris Masterson 0
Christine Fulton )(
Sue Rose 0
Dd-./ 10/ J.L
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 'g(
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
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Department Head approval:
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Date Applicant Contacted: ~ / LQ/ 1/
Date FOIL fulfilled or denied: d+ / fJI 1/
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Closed by:
Date:
Name:
Address:
Notes:
" 0 check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (
Email address:
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SPECIFIC DESC, RWTIO: o.~_
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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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