129
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by: Chris Masterson ~
Christine Fulton 0
Sue Rose 0
Date Received: '==) / li2... I ~
FOIL Ser. #:
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PLANNING DEPARTMENT
lOWN OF WAPPINGER
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING ~u S~~ ') "&l
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 ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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Date Applicant Contacted: 'Si t.L I II
Date FOIL fulfilled or denied: .L I~
Closed by: ~
Date: .r: If I I (I
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Amount Due:
Pages for a total of $
Name: N "COI 'e..
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm: C on5-\rUG.,fiun mGlno~'t1Y1U\+'
Telephone #: ( ) _- FAX #: ( ) _-
Email address:
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
I
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
~rdance 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
o I request that the records be faxed to the number listed above