136
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 0
Sue Rose 0
Date Received; ~ / ./111 ~( ;
FOIL Ser. #: ! 3 fa
DEPARTMENT:
ASSESSOR
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 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
Date Received by Dept .5... 1 .!Q.. fJ.QJ.1
Department Head approval:
Date Applicant Contacted:
(init)
1 1
Name:
Address:
Date FOI~~ed or denied: _I _I _
~iiJ~Nl S,~OS ( 1 /)
Closed by: ddl1M::10 S;~SI1 "1ft./)
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Date: OZ 0 1 AV;y _1_1
Notes: O:JI\I:J:J=1~
Amount Due: 2Pages for a total of $ ,,15
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (
Email address:
)--
FAX #: (
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SPECIFIC DESCRIPTION OF RECORD:
Qa1L
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