045
FOIL Ser. #:
Christine Fulton 0
Jessica Fulton Y
~/6- / ~
:=pt-tj5
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONL Y
Received by:
DEPARTMENT:
ASSESSOR ~
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 0
Date Received:
FOR DEPARTMENT USE ONL Y
Date Received by Dept
Department Head approval:
RECEIV~/j
Date Applicant Contacted: MAIHr 1m! -
Date FOIL fulfilled or~OF-W / / _
ASSESSOR '~6~~?c~R
/
/
Closed by:
~/-
Date:J
Notes: ()~ \ ~ <1
Amount Due:
ages for a total of $ I
SPECIFIC DESCRIPTION OF RECORD:
ILl'\"
'(L:l-drta 'kl~
I
f14
tu'-( f~ ~~, IV(
FORMAT OF RECORD (if available)
o
o
I request to be notified when I can come to inspect the record( s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
o
Ii>