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085
Received by:
Christine Fulton 0
Jessica Fulton ~
G-/5/
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT ~
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHWAY 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
FOR DEPARTMENT USE ONLY
Date Received by Dept 6- i ~
Department Head approval: f:Ii!ff
Date Applicant Contacted: ii~~
DateFOIL@rdenied: 6iJ} 0-
Closed by:
Date: 6-/r:fq:-
Notes:
Amount Due:
Pages for a total of $
Name:
Address:
o check here if you are
requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (
Email address:
FORMAT OF RECORD (if available)
o
;;
o
I request to be notified when I can come to inspect the record(s) described above
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
I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above
