195
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by; Chris Masterson 0
Christine Fulton 0
Sue Rose g...-
Date Received: 2/ Jk)LL-
FOIL Ser. #: 11/7)
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
o
y
o
o
o
o
o
o
o
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: _ / _ /
Closed by: C@
Date:
.-2 / d2/ J.L.
Notes:
Amount Due:
Pages for a total of $
$c
I
I
l0 .,'1. 1':<.5-<1[) -338be mailed to this address.
Agency or firm: 5
Telephone #: ( 9'1 5l2:B..l- 7-6 q ~ FAX #: (
Email address:
Name:
Address:
o check here if you are
requesting that the records
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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