236
Date Received:
Chris Masterson 0
Christine Fulton 0
Sux Rose J3-
~/Lk/JL
-ffc986
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK ~
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOIL Ser. #:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied:
/
/
Closed by:
Date:
/
/
Notes:
Pages for a total of $
Amount Due:
Name:
Address:
o check here if you are
requesting that the records
, /)6'90 be mailed to this address.
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SPECIFIC, DESCRIPTIONOF~~ ~
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FORMAT OF RECORD (if available)
o I request to be notified when I can corne 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