163~yg~~
2009-10-16 JCM
FOR INTERNAL USE ONLY
Received by: Michael Leonard
Jessica Fulton ^
Date Received: /~ / ~ / ~'~~
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECENER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~~ l ail /~.
Department Head approval: ~f(r-
(init)
Date Applicant Contacted: J.L l aS'/ /3
Date FO ul i le r denied: ~~ / 2S/ ~~
Closed by: ~~
Date: l ~ / °~~/
Notes: ~~ (U
Amount Due: - Pages for a total of $ • .~a
Name: ~~ G 1 a~ ~S ^ check here if you are
Address: ~ ft~ ~~~~-~`"'~ ~ requesting that the records
d. ~~ be mailed to this address.
Agency or firm: .S-el
Telephone #: (~.~) ~-~~ FAX #: ( ) -
Email address: ~"/~Q'~~- ~ ~~"~'~'~~«n" ~ ~~
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