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269
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Chris Masterson 0
Christine Fulton 0
Sue Rose ''8'
.1~..Ilk 1 -1L
-:tt OJfo q
Received by:
Date Received:
FOIL Ser. #:
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DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECENER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
1 1
Date Applicant Contacted:
(init)
1 1
Date FOIL fulfilled or denied: _I _I
Closed by: @
Date: j D I ;lJ 1 .J.L.
Notes: Pa juJ:efUlSu"e &.rt2J LR-
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Amount Due: Pages for a total of $
Name: P{!.4:ev n~K:.--
Address: 2D~ oL..l) ~(JbWtC.LL (t.o4-Q
W fto (l PIli t-i. ~ r:A-(..lJ 1-1'1'
Agency or iirm: S"a. l,.p.
Telephone#: (-g-+>) ~- i'"rrJ"" FAX#: (' -#3r
Email address: ~
o check here if you are
requesting that the records
be mailed to this address.
---,
FORMAT OF RECORD (if available)
1 request to be notified when lean come to inspect the l'ecord(s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
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