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FOIL Ser. #:
Chris Masterson
Christine Fulton
Sue Rose
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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:
Date Received:
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DEPARTMENT:
ASSESSOR 0
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CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY []
RECEIVER OF T AXES ~
RECREATION 0
SUPERVISOR J
TOWN CLERK J
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY ~
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
ILl,] 01.LE-
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Notes:
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Name: :~~\~c...rll'~~
Address: 13 ~ ~: _ '" '-'L <:::" ~
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Agency or firm: au II' "'0...:::: L.o-.VJ ('.5LV\C ~
Telephone #: (<gyS" ) 5 )'i( -I 'S~ FAX #: (ffI<) Z"JO -~~.:::;: )
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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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