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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: Chris Masterson ?"
Christine Fulton 0
Sue Rose 0
Date Received: 5-. / 1Je / JL
FOIL Ser. #: \ Y ~
DEPARTMENT:
ASSESSOR ~/
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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Name:
Address:
Date Applicant Contacted:
Date FOIL ~ or denied:
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Amount Due: Pages for a total of $
o check here if you are
requesting that the records
5 cr 0 be mailed to this address.
Agency or firm:
Telephone #: (t[ L/ ) L-/l r - 8'6 50 FAX #: (
Email address:
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SiS~~{DESCRlPTION OF RECORD:
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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