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053
FOR INTERNAL USE ONL Y
Received by:
Christine Fulton 0
Jessica Fulton ~
Date Received: .!1. / l!1 / J ~
FOIL Ser. #: 5 S
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT jt-~
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
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
~fuJ+ .3 ~
Date Received by Dept _ / ~ /
D~pi:Utlll~1it Ikoo RFPwvalf-
(init)
Date Applicant Contacted: _ / _ / _
Date FOI~fille r denied: :3 tit I J. d-
Ptutits -- ~ ~I'e..f
Closed by: )-( cr-
Date: gf S- / t.K / I;;'"
/J J I ~ /lJ 5"jle/'7-
Notes: P(!.,ft'. I .;lv - r .
. He;--
Amount Due: Pages for a total of $
Name:
Address:
o check here if you are
I ~O requesting that the records
be mailed to this address.
gf.{r- C;06 -
)-- O'1J<{
Agency or firm: L CS i n c.
Telephone #: (~6()..fl1:-l;S?O~ FAX #: (
Email address:
SPEC)E;IC DES~Ip~TI01)T OF ~CORD:
:;)f?P ~JJfJC-, ~ '
= __ _ 3/1- 'i'~ lil1
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
