055
Received by:
Christine Fulton "r/..
Jessica Fulton 0
2009-10-.16.rCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received: ll2a:J I ?-
FOIL Ser. #: 05S
..~ \NAP
,..>...~,"'../~.l..""'.
r' ..~ ."..~
.~, " '~' ",-"
'0' ,. "v
.;.. , . ,'P ,
o;.~!,~
~, <<l';""~"::" . / ;,:'i
c.~.". ..:....J
~~,,,./~A..,
5S co~ . .
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZON]NG 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK Pl
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ 1
(init)
Date Applicant Contacted: _I _I _
nate FOIL fuIfiIled e -1j~/d-
Closed by: @
Date: ..31[JC;/ /d .
Notes: em~d (t-JO l<ouxzAs)
/ ./
Amount Due: ."L.Pages,for a total of$ ./
Name: Alyc It.. . &:. OVEKmY~I~
Address: 107 ~ KtH.TE q. rvi~ J./
F.sM~,Jt /l)lj t:2~:Jq
Agency or :firm: )eL F
Telephone #: ('1," ) 4$Q- tot 3F AX #: (tjHI ) ~- lkr.t.
Email address: LE.
o check here if you are
requesting that the records
be mailed to this address,
SPECIFIC DESCRIPTION OF RECORD:
7'1:Ie EJyllt,",-/~ FiJif: 'Pu. ~tvTcl<<;1? 1t;, inllt:wcrc /o('ckd tJn ti/;'JiI'lJ !'j~
"'1 IJA{lI'JT!}"r:1O Ii//(.
FORMAT OF RECORD (ifavailable)
[j I request to be notified when I can come to inspect the record(s) described above
IJ I request copies of the records described above and agree to pay theeost of such records in
accordance with the fee schedule on the back of this application
K 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