101FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: ~ / ~ /
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING ^
CODE ENFORCEMENT ~ ~1~"
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
RECEIVED
JUN 2 0 2012
TOWN OF WAPPINGE
ASSES ~OR'S OFFIC
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ /z( / /~
Department Head approval:
(init)
Date Applic Co tacted: (0 / Z/ / / Z
Date FOI fulfilled r denied: (~ /~Z / / ~ Z
Closed by:
TOWN OF WAPPINGER ~
DatASSE ~ S OFFI!'''E ~ / Z- / / Z,
29 MidBd'sh Roa
No{+@~GL~pln~ers Falls. I~a.Y. 12590
Amount Due: ~ Pages for a total of $
Name: A.. ~-S ~ Q ^ check here if you are
Address: 5 ct ~ requesting that the records
~ rl `~ be mailed to this address.
Agency or firm: I zS 4 (~
Telephone #: ( ) - ~ FAX #: ( ) -
Email address: C~
SPECIFIC DESC TIO~,N O,F RECORDS,, /
L !~V ~ ''
Irv
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
^ I request that the records be sent via a-mail to the address listed above
^ I request that the records be faxed to the number listed above