014
Received by:
Christine Fulton vA
Jessica Fulton 0
Date Received:
01 /}~ / Id-
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR ~
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
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
RECENEO
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fliRt: INSPECTOR
10WN OF WAPPlNGER
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: / /
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Amount Due: Pages for a total of $
Name: E:. \ .e.
Address: ~;,;~;~~nfu1is ~\;;)S76
Agency or firm:
Telephone #: (~$) cl[L- Ql.f~ FAX #: ( ) -
Email address: qlCf- 1./9 t/ (:50~D ~)
o check here if you are
requesting that the records
be mailed to this address.
on rYO~('-hr Qbue. +~rn
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