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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 []
s~e Rose ~
Date Received: _/.61I.LL
FOIL Ser. #: t1d~ 0
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 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:
.!L/aal11-
~
(init)
1 1
Date Applicant Contacted:
Date FOIL fulfilled or denied: Jt / ~ 1 J.1.-
Closed by:
1JflA
..:is- 1 d:i / lL.
Date:
Notes:
Amount Due: ~ Pages for a total of$ (). l~
Namekf" c.. {('t-d'LleJQw<r
Address: q~ c.c..e.mJ\e.. ~<<-
lu^"P'f1S"rs '::f..q(l"l. AlI12'3:>f'o
Agency or firm:
Telephone #: ( ) _- FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
) -
s~ DE~ION OF 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