073
Received by:
Christine Fulton 0
Jessica Fulton ~
'2-/lL/lf
'7S
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
O~ 'I!,!-fPI. ....
$~' /'. .:'.>':c~.'
'0 / . "v"\'Sl
:1- : . I, ~
Q ~~'!~.
c.~ /",:.
"^ \, . 'A,. /
,(>~" . >~ .
. ~ss co~ .
FOIL Ser. #:
DEPARTMENT:
ASSESSOR ~
ACCOUNTING ~D
CODE ENFORCEMENT 0
PL~G 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 0
RECENER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONL Y
Date Received by Dept _ / _ / _
Department Head approval: REC~
MAY 03 2912
Date Applicant Contacted: _ / _ _
TOWN OF WAPPINGER
Date FOIL fulfilled or denfe1P.ESSQR's dF.ElCE
Closed by: ~
Date:
/
/
Notes:
Amount-Due: -1-.pages for a total of$ I dS-
Name: G-r~+ Ac--~~17
Address: Z ~ /,^c I l.. r!--
f \) '>J .r \... I c- e...e.. /I J I L..
Agency or fIrm: t-.. p. l-1 v' ~ ~ {( r c c>
Telephone #: (l4\/)Lt01 - '0("" FAX#: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
)
SPECIFIC DESCRIPTION OF RECORD:
f'L Co,....! Co- 1
/ /::;0 'f
~f- <\'
FORMAT OF RECORD (if available)
o
o
I request to be notifIed when I can come to inspect the Tecord(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 requ~st 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
o
T