77
FOR INTERNAL USE ONLY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
Received by:
Christine Fulton 0
Jessica Fulton '%
Date Received: 0 / J 3 / j ~
FOIL Ser. #:
..' " ()~ ~APp
~~./..., ~.~+..
~. A . ., . ~ .,"~
~/'. \<'j)
o\s;j;;' '. ,;..; \
~. .~:
; ,.. . )~..
'-;s.;' .... / A.../
. . ~s!; c~~~
DEPARTMENT:
ASSESSOR 0
ACCOUNTING ~.
CODE ENFORCEMENT e>
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
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date Applicant Contacted:
/ /
Date FOIL fulfilled or denied: - /;r I _
Closed by: sd4..-
/'
Date: .s /~3 / J ~
Notes:
Amount Due:
Name:
Address:
}/JI f:.vc L G~7:;
2 2- /~i-1D,J ~
ee~ I J-Jj 11-~OrP
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (911) f"1><; - rift FAX #: (
Email address:
)--
SPECIFICDES:RIP~N O~~ORD: t- ~ ~
:T lH +- . rdt - -
)f'J~",/Lt ) A>/ /2 ("30
FORMAT OF RECORD (if available)
~ 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