272
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
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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
ACCOUNTING 0
CODE ENFORCEMENT -:&.
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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Date Applicant Contacted: 1-2:. 1 -2. / /0
Dale F~ denied: I:J-I 7 II ()
Closed by: II (}-
Date: '" # AvA-,J0 . 12-- / ~/ /0
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Amount Due: _ Pages for a total of $
Name:
Address:
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Agency or firm:
Telephone #: ( ~'1 <))..:3:1!.-- C)"',' 7~i
Email address:
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o check here if you are
requesting that the records
be mailed to this address.
FAX #: (
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SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
o I request to be notified when 1 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