255
FOIL Ser. #:
Chris Masterson 0
Christine Fulton "fi
~ Rose D
/QUI lL
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR INTERNAL USE ONLY
Received by:
Date Received:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
pLANNING ~
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept 1- I ~'t-)I{
Department Head approval:
Date Applicant Contacted: 1 1 Zi. 1 II
Date FOIL fulfilled or denied: _cr 161 ! I
Closed by: ,:tt:)
Date: .!!L 1 U; ! /
Notes:
Pages for a total of $
Amount Due:
Name: 11 ~y J) tV {?cJ r1/nv /1/
Address: I f/ ~ /t;C r .~c.
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Agency or firm:
Telephone #: (8'/1 ) ')'17 - :3 7; t FAX #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
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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