307
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton ~
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Received by;
Date Received:
FOIL Ser. #:
~APP,
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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FOR DEPARTMENT USE ONLY
/ /
Date Received by Dept
Department Head approval:
(init)
Date Applicant Contacted: _ / _ / _
Date FO~~. or denied: /;) / t- / A
Closed by: (:Y-
/
/
Date:
---
Notes:
Amount Due:
Pages for a total of $
Name: 1/f Pc crl m 1- 1-.
Address: .rJee, }fill DR
~, "(lo'-J.L"'~CIL/
Agency or firm: .Q... .
Telephone#: (,~/5');AQ L~' ~ FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD: .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