082
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 ONL Y
Date Received: {Q / '-/ / 10
FOIL Ser. #: 9?
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DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
.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
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(init)
Date Applicant Contacted: ~ / 1- / / '2-
Date Fo~r denied: fL / .!L.. / I..L
Closed by: M. 6-
Date: !.a- / !:L / ~
Notes: C6 tJiLo - ~ "tJ <t,J- ~ -::FO
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Amount Due: Pages for a total of $
Date Received by Dept
Department Head approval:
Name: Ctf' _ ed.o-Tz;- 0 check here if you are
Address: ~ 0 5Ds.u.v> D" requesting that the records
o~~ \)~ b. 'l: \~IO be mailed to this address.
Agency or firm: ()J.....\ C-0 ~
Telephone#: (~IL\ )$- d - FAX#: ( )_-
Email address: S ;;l.... ~D " c
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
CY 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