049
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Received by:
Christine Fulton ~./
Jessica Fulton ~
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received: ~ / '2 / 151-
FOIL Ser. #: 041-
DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0
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:
/ /
(init)
Date Applicant Contacted: _ t?~/ _
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Date FOIL fulfilled or ~~ 3;~ 7"
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Closed by:
Date:
Notes:
Amount Due: 3.- Pages for a total of $ I / S'-
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Name:~~~~~~ ~L~CGC
Address: L iCt €. 7(1)
tJl&f'P/~bEJ?S fALlS ~y
Agency or firm: .s~ L i- J ,
Telephone#: (~S")~- Dbb~ FAX#: (
Email address:
)( check here if you are
requesting that the records
I ~ S'''Io be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
:Of:. ED r::DR 1./) pJA<:.FfV~.L~N l:. Rb
W ~ p to uJ ~ E e..s F' ALes. f!.Y 7 ~ S'9 t\
FORMAT OF RECORD (if available)
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
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