025
Received by:
Christine Fulton 0 /
Jessica Fulton ~
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
~/~/!JDJ9
7R~
FOIL Ser. #:
DEPARTMENT: '-/
ASSESSOR 2!>
ACCOUNTING D
CODE ENFORCEMENT D
PLANNING D
ZONING D
FIRE INSPECTOR D
HIGHWAY D
RECEIVER OF TAXES D
RECREATION D
SUPERVISOR D
TOWN CLERK D
WATER/SEWER D
DOG CONTROL OFFICER D
TOWN ENGINEER D
TOWN ATTORNEY D
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
-2/~_))~
~1
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: ~ / 3 /.lL
Closed by:
NVIt
-2!2/~
Date:
Notes:
Amount Due: ~ Pages for a total of $ (). <;b
Name: '~p 1vtJe...r- 3, VI ~~
Address: \)' f/Ju.{ me.,).7 l.a~ vZ
y~Y1 "teJ) , !l/, l/ 107 t!) i
Agency or firm:
Telephone#: (~4S)21L- 5'o7u FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DESCRlfTION OF RECORD:
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go Cc...-'" e \ }'\e \~rk,{s LJ",-p{Jn)"e.-r -f.~ ,h I ).)-~U
FORMAT OF RECORD (if available)
o .. I request to be notified when I can come to inspect the record(s) described above
W- 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