020
Ql/26/12 03:47PM EST '8668281228' -} 18452970579
--'
Pg 2/4
- - ~6 3 - / ~
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL RE9UEST
Received by:
Christine Fulton ~
Jessica Fulton J
Date Received: QL alII ~
FOIL Ser. #: OdD
C)
~Qp
~""",
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION IJ
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINPER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
I I
(init)
Date Applicant Contacted:
/ I
Closed by:
I
Date FOIL fulfilled or denied:
Date:
Notes:
Amount Due:
Pages for a total of $
Name: 0 check here if you are
Address: l:, requesting that the records
I be mailed to this address.
Agency or rum: (uIJO(E -1 loN'll R!~-
Tel~pbone #:. <r~. ~;^i~l:; 1 FAX ,#: (1fulo) ~- 1.22 ca'
Bmad address. :;:,. Co P'^
SPECIFIC DESCRIPTION OF RECO~
e"",,(/ ifgIj2i,J~'-' ~ s,-aud
(Jt( OlA ",fi ~ \ S'SlJ
i6
of Q44f
~^I [)p(lI/l'1s
,
FORMAT OF RECORD (if available)
:::::--:-
~
.;........ ii"8Oi'.a.
--.
~
~
I request to be notified when I can come to inspect the record(s) described abov.e ~r=
I request copies of the records described above and agree to pa.y the cost of such recor~{;;clV.
accordance with the fee schedule on the back of this application JAN
I request that the records be sent via e-mail to the, address listed above 2 7 201
I request that the records be faxed to the number listed above ~UOJLDING Dl;p"h
" WN 'VOTM
NGER