252
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
~'8 FOIL REQUEST
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FOR DEPARTMENT USE ONLY
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose y
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Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
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Date Apphcant Contacted: TfSSf:ssepJ~ICE
Date FOIL fulfilled oxR~I\lEJZ)_ / _
Date Received by Dept
Department Head approval:
Closed by:
Date:
Notes:
Amount Due: L Pages for a total ofsd ~
Name:
Address: a...o .A S
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Agency or firm: /fJ1S g fl.
Telephone #: ( (m ~- 0\-).. }" FAX #: (
Email address: --
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRIPTI& ,F ~~J ~ _ 4- ;2.:::J J (j-::;-
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FORMAT OF RECORD (if available)
o ~equest to be notified when I can come to inspect the record(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
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