264
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by: Chris Masterson 0
Christine Fulton 0
Sue Rose ~
Date Received: 10 / ...1L / -1L
FOIL Ser. #:
11 &~ tf
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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
o
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FOR DEPARTMENT USE ONLY
/ /
Date Received by Dept
Department Head approval:
(init)
/ /
Date Applicant Contacted:
---
Date FOIL fulfilled or denied: / /
---
Closed by: 101/ //1/
/ /
Date:
---
Notes:
Amount Due:
Pages for a total of $
WIFe
Agency or firm: ,.~I'-
Telephone #: ( rt'7) 'J{J.:L- 7 fJ Jd-F AX #: (
Email address:
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD: ,---/l ,;t; 0
~A~ry,ftlo~ cn~ ' tV2'- /, (i
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
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