048
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Christine Fulton r ~
Jessica Fulton ~
Date Received: -3- / 2 / i..[):.
FOIL Ser. #: nL( f:
Received by:
DEPARTMENT:
ASSESSOR ~ /'
ACCOUNTING ~
CODE ENFORCEMENT 0
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:
01 / 0 7 / I "L
~-
(init)
oJ / 01/ /e.,
Date Applicant Contacted:
Date FOIL fulfilled or denied: O'} / 07/ I 1.
Closed by:
PA-~no
Date:
/
/
Notes:
Pages for a total of $
Amount Due:
Name:~DoN ~~ o check here if you are
Address: , 0 ~et( OS '\ ~--1. requesting that the records
No ~&at fi..-LLs;. 'v. l-zsqo be mailed to this address.
Agency or firm: W~JPI~S~ ''''Df~S ~Au..;:~,(..
Telephone#: (9~<I)~-17"'5 FAX#: ( )_-
Email address: Ooc:.Jc..(~c.. ~ G ,..,..lL . Co W\.
SPECIFIC DESCRIPTION OF RECORD:
;fritf~ 0 Ho;ci.f.v.s t> !.t~~E>!. + ~ tin- -r.- (..j...l"f"~-->
xav+t- ~. At. L M C> lS'L st4 foe kJ \> t"A-1 f?
ovo\- IN 'Z.oll..
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