075
FOR INTERNAL USE ONLY
Received by:
Christine Fulton 0
Jessica Fulton ~
6-/2~2-
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Date Received:
FOIL Ser. #:
DEPARTMENT: ~
ASSESSOR
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
Name:
Address:
Agency or firm:
Telephone #: (
Email address:
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 ..:]/ -dY1
Department Head approval:
(init)
Date Applicant Contacted: .,:; / / ~ I
Date FOIL fulfilled or denied: / /
Closed by:
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Date:
Notes: 'i\l 0 r
Amount Due: _ Pages for a total of $
o check here if you are
requesting that the records
SPECIFIC J:WSCRIPTION. !:Ie RECORD:
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FORMAT OF RECORD (if available)
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