178
Received by:
Chris Masterson 0
Christine Fulton ~
tJ Ros,e" 0
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--
2009-] 0-16 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 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER ~
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN AITORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept (0 I,~ I
Department Head approval:
Date Applicant Contacted: ~ ~
Dare FoE;; denied: t!;JJ
Closed by:
Date: ~ G!Jf iJ
Notes:
Amount Due:
Pages for a total of $
Name:
o check here if you are
requesting that the records
be mailed to this address.
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FORMAT OF RECORD (if available)
o
o
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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