042
f
FOR INTERNAL USE ONLY
Received by:
Christine Fulton 0
Jessica Fulton .~
fJ- /~/ 12:-
t1{f
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT .
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HlGHW A Y 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
Name:
Address:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
RECE\\IEO
., .J Cl 'LD\?.
\- cO .. 0
OEPAf\TM
6U\\..OING r WAPPING
TOWN 0
0(( WAPI>
~~.._',t~
l' .' ~,,~.
:... \'"
, ':). ~.:>
~, . /~
(:I. ",:~:
. ". / ~
.y~'h" .... ~
.55 co~
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
Date Applicant Contacted:
(init)
/ I
---
Date FOIL fulfilled or denied:
Closed by:
I
Date: t eX blg:-- / .L2
Notes: !:AI ~J(J I . ( /
l ~
Amount Due: _ Pages for a total of $
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESC~TION OF RECORD: ,
R e,S~ ~vt-T\Cs... \ rUvYl,t re.fO\f'T
J 'f^!. - &03-100 ~ - '7 b ? <I
2- () / '2...
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 .
Ji4 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
".- -- """ """. .__ __ .u___