296
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 0
Sue Rose ~
Date Received: JLI I~I ~
FOIL Ser. #:
iTc776
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DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECENEROFTAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
Date Received by Dept
Department Head approval:
FOR DEPARTMENT USE ONLY
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llJ ..L:: 1 ~
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(init)
Date Applicant Contacted:
1 1
Date FOIL fulfilled or denied: iL 1 151 J..L
Closed by:
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Date:
Notes:
Name:
Address:
Amount Due: -2:. Pages for a total of $ tJ. ~
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: ~~
Email address:
FAX #: ()...?) )}'f - I"J II
SPECIFIC DESCRIPTION OF RECORD:
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