124
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson 0
Christine Fulton Jel
Sue Rose 0
Date Received: :5 / -'-/ / J..L
FOIL Ser. #: / d L-/
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONLY
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Date Applicant Contacted: 5- / ~ I -1L
Date FOII(~~~l\~ed: :;-1 L 1 ((
Closed by: - ;1( ()-
Date: ~/!i/ LL
Notes: J f I~ ·
Amount Du~.sV Pages for a total of $ .
Date Received by Dept
Department Head approval:
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: (ql(r)~- 7370 FAX#:. ( )_-
Email address: a/lo c~r t19 . e<tocJ Cd
SPEC~IC DESCRIPTION OF ,RECO~:
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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