233
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton 'l
S>>e Rose V6
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Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0 I' "
CODE ENFORCEMENT , ~
P~G 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 0
RECENER OF TAXES ')a:7
RECREATION ('0
SUPERVISOR 0
TOWN CLERK. 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
Name:
Address:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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Date Applicant Contacted: ~ / / S' / !!.-
Date F~r denied: g / / Sf !..!-.
Closed by: )./0/
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Notes:
Amount Due:
Pages for a total of $
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRlPTIOJ)l OF RECORP: (I +--
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FORMAT OF RECORD (if available)
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I request to be notified when I can come to inspect the record( s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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