302
FOIL Ser. #:
Chris Masterson 3
Christine Fulton ~
Sue Rose 0
IL/~I J.L
3DC
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
Date Received:
, ~APP/.lu
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
W ATERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
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Date Received by Dept
Department Head approval:
/ /
--
(init)
Date APPliC~"acted: _I - / -
DateFOIL~ordenied: t>~)/~
Closed by: ' @
Date: lL 1 ;:f5 iL
Notes:
Amount Due: _ Pages for a total of $
Name:
Address:
le)
Agency or firm:
Telephone #: ( otjtttJ) Jl!Sl-- :Iii;' 0 FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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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