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313
Received by:
Christine Fulton 0
Jessica Fulton ,0
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~ ./
CODE ENFORCEMENT U::r
PLANNING 0
ZONING []
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREA nON 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
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Date
Closed by:
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Date:
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Amount Due:
Pages for a total of $
Name: 'b~t'1.:l~ +u:.o..-i-Iru 11't...9... I'Y\ !\-/..[k").1 ~
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Agency or fIrm:
Telephone #: (~S )cl9.l- ,?,01 ~ FAX #: ( ) -
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)
::
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
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