244
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
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIG~AY 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:
3-1.L/ .!.L
-JJM
(init)
1 1
Date Applicant Contacted:
Date FOIL fulfilled or denied: .-i. 1 L 1 11-
Closed by:
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,
Date:
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Notes:
Amount Due: ....2... Pages for a total of $ !J 'Q)
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Name: .'':\ . r:c!/1'7~tAI'
Address: / ~ ? r~ ,lj",
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Agency or firm:
Telephone#: ('(tI~-).6~1 - z.frl-S" FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTIOl'i OF RECORD: ft
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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