165
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 rr
Sue Rose 0
Date Received: t.L /8-/ 11-
FOIL Ser. #: I Lo 5
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT )6
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 ATTORNEY 0
FOR DEPARTMENT USE ONLY
Dale Received by Dept b I ~
Department Head approval:
Date Applicant Contacted: 6 I.! I JL
Dale FO~~ denied: 6 I J1
Closed by:
Date:
Notes:
Amount Due:
Pages for a total of $
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Address: !:,oJ ,--:;v c..J f I/i ~ ....oJ J Vi"" ~
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (J;S-) ~ l - ~ 9..5 6 FAX #: (
Email address: ---- . c . r'1.#"<-." c.
SPECIFIC DESCRIPTION OF RECORD:
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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