091
Received by:
Christine Fulton tr1
Jessica Fulton 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR INTERNAL USE ONLY
SESSOR
ACCOUNTING
CODE ENFORCEMENT D~
PLANNING cr'~
ZONING Er
FIRE INSPECTOR 0
HIGHWAY ~/
RECEIVER OF TAXES ~
RECREATION 0
SUPERVlSOR 0
TOWN CLERK 0 /'
WATER/SEWER ~
DOG CONTROL OFFICER 0
TOWN ENGINEER ~
TOWN ATTORNEY 0
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Date Received: (() / 16 / I d-
FOIL Ser. #: o:r I
FOR DEPARTMENT USE ONLY
Date Received by Dept 1L / 1K / ~
Department Head approval:
Date Applicant Contacted:
(init)
/ /
Date FOIL fulfilled or denied: -1L / M.... / I )-
Closed by:
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Date:
Notes:
Amount Due: --1- Pages for a total of $ 0, ~ "\
Name:
Address:
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
~ 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
V 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