046
Received by:
Christine Fulton ~
Jessica Fulton ~
~/~/~
L/C?
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 ~l
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
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
31:{;/2-
(init)
Date Applicant Contacted: 31 S- 1 IL-.
Date FonBor denied: 3 ~ II L
Closed by: - L;fJ
31 ~I /2--
---
Date:
Notes:
Amount Due:
Name: {- L...
Address: " M(? 4.,,~~ ....-,Le.
Wa~r~. ~ .h/ff /zY /2s7b
Agency or firm: /
Telephone #: (cryrj .:?tL- J::lac~'( FAX #: ( ) __
Email address:
o check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTI~OF RECO~:
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FORMAT OF RECORD (if available)
~ 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
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