134FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton ~
Date Received: ~ / '7 / ~~
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: _ / _ /
Date FOIL fulfilled or denied: / /
Closed by:
Date: /d / 7 / / 3
Notes:
Amount Due: Pages for a total of $
Name: c CRS ^ check here if you are
Address: S ~ requesting that the records
s ~G 1J be mailed to this address.
Agency or firm:
Telephone #: ( ) - FAX #: ( ) -
Email address: .~ ~ ~ ` ~ , C ~
SP CIFIC D RIP ON OF RECORD: i
~~ ~ ~ a
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