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172
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose l!r
JLI cPt 1-1L
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
FOIL Ser. #:
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Date Received:
DEPARTMENT: '..../
ASSESSOR &.
ACCOUNTING 0
CODE ENFORCEMENT 0
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
Date Received by Dept
Department Head approval:
1 1
Date Applicant Contacted:
(init)
1 1
Date:
Date FOIL fulfilled or denied: 1 /
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Closed by:
Notes:
Amount Due:
Name:
Address:
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)_- FAX#: (
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: (
Email address:
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SPECIFIC DESCRIPTION OF RECORD:
VIE'
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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
