205
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 >Cl
Sue Rose 0
Date Received: .-) ;..::Y1 / l.!..-
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR ~O'
ACCOUNTING
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN AITORNEY 0
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
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(init)
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Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: / /
Closed by: fJ fZvtr
Date: ..::t- /~ / 1.1-
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Amount Due: Jt Pages for a total of $ J .0 ()
Name:'T5 i lJ ffi. ; l...Q
Address:, ~ ~~'1 ~J2vJJ') .
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Agency or finn:
Telephone#: (9-'{)-) J.-~y- >>/~ FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
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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