043
FOIL Ser. #:
Christine Fulton 0
Jessica Fulton ~
!i/:L/~
43
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Received by:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~
CODE ENFORCEMENT ..g;;b
PLANNING 0
ZONING 0
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
Date Received:
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval: .
/ /
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: / /
---
fl J}~/I 2-
/ /
---
~m) ~PJJ c~J -/!JOG)/) ,~/)
I
Pages for a total of $
Closed by:
Date:
Notes: J ,/)f
Amount Due:
.
Name: () 6.- c..-.<--
AddreSS:~ ~~~~ iJ~l~
5U ~ ~ ,JZ 4-
Agency or firm: ~ I ~
Telephone #: (844") m-- 5';'11 FAX #: ( ) --
Email address: MA"t.{,b-' C:}'i @1 ol-r CJJJt-o... € ~,,-
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
pL~f~ r-I [,.~ (.oL. 2 -, t5eez:.U~ C,,,t.C'Li!!:
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