090
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Received by:
Christine Fulton .~
Jessica Fulton a
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
Date Received:
RECEIVED
JUN 1 j 2012
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FOIL Ser. #:
DEPARTMENT:
ASSESSOR 0
ACCOUNTING 0
CODE ENFORCEMENT X
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
BUILDING DEPARTMENT
TOWN OF WAPPINGER
FOR DEPARTMENT USE ONLY
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Date Applicant Contacted: ~ / fJ / I;J...
Date FO~r denied: c; / /..3/ I 2-
Closed by: Jl( 6-
Date Received by Dept
Department Head approval:
Date: r
Notes: f\I ()
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Amount Due:
Pages for a total of $
Name: " ~Y\ ~u..eJU..,
Address: la..~ Cct.c ~ \)('.
W~'~\~J\~~ 1\
Agency or firm: ~
Telephone#: (q/tf) 75S-&dSf? FAX#: (
Email address: l
o check here if you are
requesting that the records
\0'( \dS~O be mailed to this address.
S ECIFIC DESCRIPTIO:N OF RECO~:
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