247
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 9 /"
Sue Rose V"
Date Received: !l.- / b- / JL.
FOIL Ser. #: # Q) V 7
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0 Y 16-
CODE ENFORCEMENT 's:::[ f./\
PLANNING 0-
ZONING 0
FIRE INSPECTOR 0
HIGHWAY ~
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER ~
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
I /
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied:
/
I
Closed by:
Date:
/
/
Notes:
Amount Due:
Pages for a total of $
Name: I'vf Ie I-H1-f!:L ('II/Net<
Address: / tVeNfJY 11 ofr (J
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o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: (0YS) 'U>~ - /Cll, FAX#: ( )__
Email addresS:MINCiZI/.O.:-of>...frofIJt..-.Ne.N r5-1
TION OF RECORD: ftt'Iv .rL"W~
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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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