131FOR INTERNAL USE ONLY
Received by: Christine Fulton 0
Jessica Fulton
Date Received: ~ / ~j /
FOIL Ser. #:
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT
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
FOR DEPARTMENT USE ONLY
Date Received by Dept f ~ / ~' / l ,3
Department Head approval; ~~G-'
(init)
Date Applicant Contacted: /d / ~ // 3
Date FOIL fulfilled or denied: /O / ~ /
Closed by:
Date: l0 / ~ /
,c~~,
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: J
Telephone #: (C~ _)- - FAX #; ( _
Email address: ~~{p~ /h (,,~ ~ j ~ ,r~,~
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