012
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by:
Christine Fulton 0
Jessica Fulton ~
Date Received: --L / 13' ~
FOIL Ser. #: 0 I Q-
.' o'ft WAPJ',)
"~'~,'!B/'.... '~~~.""
o / .' <, -. '. ~\
',I- I "'Ii".
'\'O\~' .>1
s.,,;ti
~. . /~.,
. . A A.. '
+('5 -,,;.,,<\.~ /
,_5. cO"
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT g'
PLANNING 0
ZONING [t:(
FIRE INSPECTOR [1(
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER [g/
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY ru/'
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied:
/
Closed by:
Date: L/ J;3../a2Q(6t
Notes: if~QIJ)1hjuL
Amount Due: Pages for a total of $ t lit
Name:
Address: 0
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (gLli) 2Lj'2 - '-199) FAX #: ( )_-
Email address:
SPECIFIC DESCRIPTION OF RECORD:
~) l~ Fo Ar>~ 1C M V~ L) (OM CV\J) (Z()
I
FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record( s) described above
g/' 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