268
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
~ue Rose 'Q/
I OI.iU J.l. 0
1tr9~t
Received by:
Date Received:
FOIL Ser. #:
~ VWAPp
~,~.. '~~,-",~/.t,
~ ,.. , ' : -' "~~'
,0,: ..,~
'~.~\,~'
c;.' " " fZ:,
.""" r'~.'
(", ",A.,'
~~is .. co~~
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
o
o
o
o
o
o
o
o
o
y
FOR DEPARTMENT USE ONLY
I I
Date Received by Dept
Department Head approval:
(init)
I I
Date Applicant Contacted:
---
Date FOIL fulfilled or denied: - fr I -
Closed by: ,J 0/7 f )
I I
Date:
---
Notes:
Amount Due: _ Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: ( 94r'J 2fl:j
Email address:
)--
SPECIFIC DESCRIPTION OF RECORD: ~
c.. /YVW~ ''11' r(ll ~ J ~
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