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119FOR INTERNAL USE ONLY
Received by: Christine Fulton ^ ,
Jessica Fulton ~'
Date Received: ~ /~/
FOIL Ser. #:
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT _
~N'
PLANNING ^
ZONING
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER 0
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
-FOIL REQUEST
Date Received by Dept
Department Head approval:
Date Applicant Contacted: _ / _ /
Date FOI ful lied or enied:
Closed by:
Date: / _ /
Notes: ~ ~~M~-- C °~--
~~ , u-a Coo
Amount Due:~-~""Pages for a total of $
Name: C-r.
Address: ~ c>
Agency or firm: ~ ,,~ c
Telephone #: (~ (c~) ~~- '1 FAX #: ( )
Email address: l7oc~k.~ n~a ~ Gwt~•~(. • C~ .
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
^ I request 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
^ I request that the records be sent via a-mail to the address listed above
^ I request that the records be faxed to the number listed above
^ check here if you aze
requesting that the records
be mailed to this address.
