130FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: 1C~/ ~/
FOIL Ser. #:
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT ^
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept _ / _ /
Department Head approval:
(init)
Date Applicant Contacted: / ~ / 14' / 13
Date FOIL fulfilled or denied: l~ / l ~ /) 3
Closed by:
Date: / /
Notes:
Amount Due: Pages for a total of $
Name: I ^ check here if you are
Address: ~ ~ requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (G~ )~ - F #; ( _
Email address: - ,/a'' _ ~ G{ ~ , (~' ~,~
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