058
Received by:
Christine Fulton 0
Jessica Fulton ~
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058'
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONL Y
Date Received:
FOIL Ser. #:
DEPARTMENT: ~
ASSESSOR P
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
RECEIVED
Date Received by Dept _ / / _
Department Head approval: MAR 2 8 2012
(init)
TOWN OF WAPPINGER
Date Applicant Contacte<f..SSESSO~.'S OfFICE
Date FOIL fulfilled or denied:
-'-,
Closed by:
Date:
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Notes:
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Pages for a total of $
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Amount Due:
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Address: I i:l v vv\. IV'\t' t'-' O.N Ltt. tU.... requesting that the records
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Agency or firm: ~"\~ ~~?'-I
Telephone #: (8Yr- tZ:!:!L- '7fo.-3 FAX #: ( f1f.r) f'!!j - /.;. 1.1 & .s
Email address:1)prOJl.llo(o>hvc.(Y.Cd.....
SPECIFIC DESCRIPTION 01; RECO:&J): A I j.
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FORMAT OF RECORD (if available)
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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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above