311
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~'
/ }- / I..::L / J..L
Date Received:
3//
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0'
ACCOUNTING 0
CODE ENFORCEMENT 0'
PLANNING 0
ZONING [J
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES r1 ,~ 3 / /
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
()
Name: -
Address:
I
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:
/ /
(init)
Date Applicant Contact~EGg".ED/ _
Date FOIL fulfilled or d~t --l-4/'lilll/ _
Closed by: TOWN Of WAPPINGER
ASSESSOR'S OFfICE
Date: '- - / /
Notes:
Amount Due: ~ Pages for a total of $ (). ~O
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm: +;f5 {~ ( ;/1 (tA1 &fwt^bn c..-~
Telephone #: (ty~n tlL: ~ r 3 b FAX #: ( ) -
Email address:
SPECIFIC DESCRIPTION OF ~CORD: j. '., ,/ 11 j
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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