009
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton 0
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Received by:
Date Received:
FOIL Ser. #:
,&-#9
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RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY . 0
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Agency or firm:
Telephone #: ( 'Ill{) '::tiL.~h <).tJ FAX #: (
Email address:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
Name: -I-
Address:
FOR DEPARTMENT USE ONLY
/ /
Date Received by Dept
Department Head approval:
(init)
/ /
Date Applicant Contacted:
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Date FOIL fulfilled or denied:
/
/
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Closed by:
Date:
/ /
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Notes:
Amount Due:
Pages for a total of $
"
r 0 check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION 0," F REC~.:
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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