174
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 ~
Sue Rose 0
Date Received: LL /dl / IL-.
FOIL Ser. #: Ji CJ
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DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECENER 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: :or4
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Date FOIL fulfilled or d~:\. _ / ~ / _
Closed by: Q-:;t'\-:;') ':f:tJ
Date:
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Notes:
Pages for a total of $ 1-
Amount Due:
Name: _FlaVlC(",,~ i3 IOlcVI
Address: ~ ~+r/r+ ~
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Agency or firm:
Telephone #: f1 /</ ) 4, L/ - r 4"5/.IJ FAX #: (
Email address:
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o check here if you are
requesting that the records
be mailed to this address.
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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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