008
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
0/67- OJ -
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Received by: Christine Fulton ~
Jessica Fulton 0
Date Received: L / ~ / I ~ .
FOIL Ser. #: DO "25
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT fJ
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 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:
/ /
(init)
Date Applicant Contacted:
/ /
Name:
Address:
Date FOIL fulfilled or denied: / /
Closed by: ~
Date: . ) /10/ J c2
Notes: ~'i VAl ~j) Ll1a C.OU!/~.
I
Pages for a total of $ .
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (
Email address:
SPECIFIC DESCRIPTION OF RECO~
~4 hf"'IUf ~
FORMAT OF RECORD (if available)
o 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