074
FOR INTERNAL USE ONLY
Received by: Christine Fulton ~
Jessica Fulton 0
Date Received: 2/.Y-/ /1'
FOIL Ser. #: () 7 L(
DEPARTMENT:
ASSESSOR 1\
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
IDGHWAY 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
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept 5' /1/ /:1.
Department Head approval: l:1fi:...
(init)
Date Applicant Contacted: S / ~ / L2...
Date FO~denied: ft L/ a
Closed by: H 0:-
Date: ~ f / /7-
Notes:
Aplount Due: _ Pages for a total of $ .
Name: DP,t-lI(3... ~J'~f~
Address: t CgJ~iL4J"'lC:: L
W ^ff,N0eu,j f.PtI..U . N "1
Agency or firm: rJ{ I>r '
Telephone #: (14r)..K1L- -;rIT4- FAX #: (
Email address: ~~I(X€."'o'\~^\L.(()~
o check here if you are
requesting that the records
I ~ fT1 u be mailed to this address.
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SPECIFIC DESCRIPTION OF RECORD:
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FORMAT-OP-REeeR:J)-(if'available) -
o I request to be notified when I can come to inspect the recoid(s) described above
if 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