061
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FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by:
Christine Fulton "'i..
Jessica Fulton 0
Date Received: ~ I) 0 I 12
FOIL Ser. #: OUn
DEPARTMENT:
ASSESSOR D
ACCOUNTING D
CODE ENFORCEMENT ~
PLANNING D
ZONING D
FIRE INSPECTOR D
HIGHWAY D
RECEIVER OF TAXES D
RECREA nON D
SUPERVISOR D
TOWN CLERK D
WATER/SEWER D
DOG CONTROL OFFICER D
TOWN ENGINEER D
TOWN ATTORNEY D
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
4 I It) I I ?..-
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He;-
(init)
Date Applicant Co tacted: ~ lId I / "l.--
denied: (.,..( 1/ (j 1/ L-
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Closed by:
Mu-
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CO/'I E..5
Date:
Notes:
-z...
Amount Due:
Pages for a total of$
Name:
Address:
A/V A/y
Agency or firm: c.'F:: r< J:2
Telephone #: ~(~).7!.L...-
Email address:
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FORMAT OF RECORD (if available) I
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