081
Received by:
Christine Fulton ~
Jessica Fulton 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
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Date Received: 5- i32 / J;;;;
FOIL Ser. #: '6 / .
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNrnNG 0
ZONING 0
FIRE INSPECTOR 0
IDGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVlSOR 0
TOWN CLERK lB"'"
WATER/SEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN A TIORNEY 0
FOR DEPARTMENT USE ONLY
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(init)
Date Applicant Contacted: ~ /?:D / -=--
Date FOIL fulfilled or denied: tIL / tL /Q;Q1'd-
Closed by: @
Date Received by Dept
Department Head approval:
Date:
/
/
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
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o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone#: ('7'/~) ~p ~ FAX#: ( )_-
Email address: e. ~ ~IA/LI'~~
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SPECIFIC DESCRIPTION OF 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
iJ 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