190
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 0
Sue Rose 0
Date Received: / /
FOIL Ser. #: I q 0
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 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
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(init)
Date Applicant Contacted: ~ / IV; ! (
Date FOI~or denied: ~ / I c;r / I I
Closoo by: d Jv/~
Date: -f' ~ ~ ~ ,1(2 / ./8 7 / / ? / ! (
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Notes: 1/7 t?5. @ . Z .(' ~ p ~ 2..-1.
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Amount Due: Pages for a total of $ $" &.
Date Received by Dept
Department Head approval:
Name: . r;!<.A -:r;:c 0 check here if you are
Address: 0 0 /::-- O(J S requesting that the records
ffi.,fJflN.Y. 1(/ Y / ;;lc2/ / be mailed to this address.
Agency or finn: I HIA_/LLEZ-. F;~.b. G~L6 AuTI.Ete ~ lo~tJG-
Telephone#:(.57~ )45.5 -?1~2- FAx#: ( )_-
Email address:
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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 nmnber listed above