316
FOR INTERNAL USE ONLY
Received by: Christine Fulton 0
Jessica Fulton .K
Date Received: .La / ~/ -1l
FOIL Ser. #: gIG
DEPARTMENT:
ASSESSOR 0
ACCOUNTING [] )
CODE ENFORCEMENT g
PLANNING 0 J
ZONING *
FIRE INSPECTOR []
HIGHWAY []
RECEIVER OF TAXES D
RECREATION []
SUPERVISOR D
TOWN CLERK D
WATER/SEWER D
DOG CONTROL OFFICER []
TOWN ENGINEER 0
TOWN ATTORNEY D
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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Date Applicant Contacted:
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Date F~ denied: I ).. /;JJ / !.L.-
Closed by: ~ ~ G-
Date: ~ Cd/ if,J/ LL
Notes:
Amount Due:
Pages for a total of $
Name: 6,... '(l: " \42. \ \'-'\
Address: lAC) A.\, "" ~ \0."\ Av ~ -
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Agency or firm: ~~-"--Q!o.<'" 0..:>er Pl<.o\. 'too!' ~
Telephone#: (~/r) 471 - 1/30 FAX#: (b''Is. ) 47(' -.)C);5'7
.
Email address:
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
.x I request to be notified when I can come to inspect the record(s) described above
o 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 '
o I request that the records be sent via e-mail to the address listed above
o I request that the records be faxed to the number listed above