199
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose 'g.,..----
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR R
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:
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(init)
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Date Applicant Contacted:
Date FOIL fulfilled or denied:
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Closed by:
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Date:
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Amount Due: '6 Pages for a total of $ (). <7.c;-
Name: 5ol//Z,/ ~Coc:.;(e'-
Address: It;:? L /<~ r <-/(-/J./y/1()t.<).-c/' /LJ.
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Agency or firm:
Telephone#: ~YJ )..<77 -7/7{f FAX#: ( )_-
Email address:
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCtrl~O~ RECORD:
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