015
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
Christine Fulton _ ~
Jessica Fulton ~
L/Ei~
OlS
RECEIVED
JAN 1 8 2012
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING W
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
B 'LDING DEPARTMENT
WN OF WAPPINGER
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date Applicant Contacted:
Date FOIL fulfilled or denied:)!. I
Closed by:
Dme: 1-/)! /)~
Notes: ~~dJ . ffI]~
Amount Due Pages for a total of $
o check here if you are
requesting that the records
~ be mailed to this address.
, {jJ5jl-1
)--
Name:
Address:
Agency or firm:
Telephone #: ~tr))!i6!f-- II( FAX #: (
Email address: 'i ]o}
/ /
---
SPECIFIC DESCRIPTION OF~CORD:
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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