232
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
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2009-10-16 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
ACCOUNTING
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
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(init)
Date Applicant Contacted: 9 / / S/ I (
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DateFO~enied: .1:..// s"/ II
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Date Received by Dept
Department Head approval:
Closed by:
Date:
Notes:
Amount Due: _Pages for a total ofS
Name: ~
Address: rL-
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Agency or firm: ~-V1 (_' L.? ~ L-~ I'f}rz c e-
Telephone #: (J' yr) ~- :f? 3b FAX #: ( )
Email address:
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
o I request to be notified when I can come 10 inspect the record(s) described above
o I request copies of the records described above and agree to pay the cost of mch records in
accordance with the fee schedule on the back of this application
o I request that the records be sent via ~mail to the address listed above
o I request that the records be faxed to the number listed .abov.e