068
FOR INTERNAL USE ONLY
Received by:
Christine Fulton 0
Jessica Fulton ~
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Date Received:
FOIL Ser. #:
DEPARTMENT: ~
ASSESSOR
ACCOUNTING ~
CODE ENFORCEMENT
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECEIVER OF TAXES !
RECREATION
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
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FOR DEPARTIMRNT USE ONLY
Date Received by Dept -<I I 11 I / A
Department Head approval: NO-
(init)
Date Applicant Contacted: '::L I I 7 I / ~
DateFOI~denied: q I ill /J-.
Closed by: 11 r # C-
Date: <f-/7-1;z, :L 1/2 I /2-
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Amount Due: _ Pages for a total of $
, Name: '"ZIJLtJf!;U, S/;V 6Jk_
Address: 1/7: OS'1roK'~6 !riLl teD
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Agency or finn:
Telephone #: (811S)8d-t??lJ? FAX #: (
Email address:
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requesting that the records
be mailed to this address.
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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
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