279
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
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Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Name:
Address:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
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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 $ -
o check here if you are
requesting that the records
be mailed to this address.
FAX #: (
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SPECIFIC IlE~CRIPTIONOF~OI1.I2:&@~1YI~
~~;~
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