117FOR INTERNAL USE ONLY
Received by: Christine Fulton
Jessica Fulton ^
Date Received: ~~ / ~ / 1 o~
FOIL Ser. #:
DEPARTMENT.:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT f~/
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
Name:
Address:
Agency or firm: Q I (,~
Telephone #: ($~) ~_-
Email address:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ? / ~ ~ ~~
Department Head approval:
(init)
Date Applicant Contacted: ~/ ~~
Date FOIL fulfilled or denied: ~ /o~ ~/ ~~
Closed by: i~
Date: 2 /a y l l~
Notes: `
Cyp ~~ ~ ~~~ dw-Nyr- --
Amount Due: Pages for a total of $~~
i ^ cheZ~c here if you are ~' ~
requesting that the records G
be mailed to this address.
FAX #: ( ) -
SPECIFIC DESCRIPTION OF CORD:
1 ~
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