133FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: ~ / ~0 /
FOIL Ser. #: ~j
DEPARTMENT: /
d
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
Date Received by Dept 0l jT 1 ~ 2013
Department Head approval: ,~~I~~7~'~i
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Date Applicant Conta~~~?NIc,~q~~3$SFi
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Date FOIL fulfilled or der~~ ~ ~ ~ /
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Closed by: Q,~';1~
Date: / /
Notes:
Amount Due: Pages for a total of $
Name: P L b L~.( 5/~ ^ check here if you are
Address: requesting that the records
be mailed to this address.
Agency or firm: 5 -~ ~ ~ G-.
Telephone #: (q'!~,) ~~a FAX #: ( ) -
Email address: ~.ro [S ~2> X32; ~c~ C° y ~a
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 e-mail to the address listed above
I request that the records be faxed to the number listed above