037
Received by:
Christine Fulton 9 /
Jessica Fulton ~
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=rt37
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING ~
ZONING 13'
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W ATERJSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept J- 1 n 1 I ~ j[J...
Department Head approval:
(init)
Date Applicant Contacted: 2-1 (7 1 I L
Date FOIL fulfilled or denied: 1-1 ( 71 12-
-~Q
Closed by:
Date:
4,111 I L
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Pages lOr a total of $
Notes:
Name:
Address:
Amount Due:
Agency or firm:
Telephone #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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FAX#: (
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SP.J;jCIFIC DE.SCRlPTION O~RECo,RD: (, ( _ I
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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