314
FOIL Ser. #:
Chris Masterson
Christine Fulton
~'W Rose
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2009-10-16 J(
TOWN OF W APPINGEF~
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING OJ
CODE ENFORCEMENT rJ
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY []
RECENER OF TAXES J
RECREATION []
SUPERVISOR J
TOWN CLERK J
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY CJ
FOR DEPARTMENT USE ONLY
Date Received by Dept fb- / 20/ II
Department Head approval: J::J.ti
- ~init)
Date Applicant Contacted: I ZA 2. 0 / !.!-
Date~~denied: !LI t.o //1'
Closed by: I!{ 6-
Notes:
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I"l..- /.!:.!!. / II'
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Date:
Pages for a total of $
Amount Due:
SPECIFIC DESCRIPTION~F RfCORD:
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o check here if you are
requesting that the records
be mailed to this address.
-~
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