93FOR INTERNAL USE ONLY
Received by:
Christine Fulton .~
Jessica Fulton ^
Date Received:
FOIL Ser. #:
CP / ~ ~ / 12r
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DEPARTMENT:
ASSESSOR
ACCOUNTING 0
CODE ENFORCEMENT ^ r
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES L~'
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER
DOG CONTROL OFFICER ^
TOWN ENGINEER ,
L7
TOWN ATTORNEY 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ /~ g / / Z
Department Head approval:
~~ ~~ ^ h~/ (init)
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Date Applicant Contacted: _ / _ / _
Date FOIL fulfilled or denied
Closed by:
Date:
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Notes:
Amount Due: Pages for a total of $
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Address: ~ >2 requesting that the records
d be mailed to this address.
Agency or fum: JU,p Q Sdn) ~~'~ C ~~~,~,
Telephone #: ( <<-() /~ ~3 FAX #: (~l ~) 77-
Email address: G> i'cJ o ~ i ' . Cdyl.~
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
ti~ 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
FOR INTERNAL USE ONLY
Received by:
Christine Fulton ,~j
Jessica Fulton ^
Date Received:
FOIL Ser. #:
CP /fit ~ / t ?s
q
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
^ ,
FIRE INSPECTOR ^
HIGHWAY ^^
RECENER OF TAXES ly'
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER f~"
DOG CONTROL OFFICER ^
TOWN ENGIl~TEER
TOWN ATTORNEY ^
Name: ~ /~i.~ ,f31'
Address: 3 ~ 6 d2 L,'
Agency or firm:.j(1"p 0 SG
Telephone #: ( < <O IZr ~3.
" Email address: ~,b lruhon~, i ~
SPECIFIC DESCRIPTION OF RECORD:
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for "Public Access to Records
FOIL 1~EQ VEST
,, ,
FOR DEPARTMENT'USE ONLY
Date Received by Dept _ / _ / _
Department Head approval:
(init)
Date Applicant Contacted: _ / - /
Date FOIL fulfilled or denied: / /
Closed by:
Date: ~ / Z/ r Z
Notes:
~o t Due:
~ r ~
_ d ~
~ 1~~7
FAX #: (~l )
.i~ _~ _. _
Pages for a total of $_
. ^ check here if you aze
requesting that the records
be mailed to this address.
Cg'y~-~
FO/RMAT OF' RECORD (if available)
L7 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
4~ 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