124FROM :DUTCHESSKNOLLSINC FAX N0. :8457652075 Aug. 03 2012 12:01PM P2
FOR INTERNAL USE ONLY
Received by: christinc Fulton
Jessica Fulton Cl
Date Received: ~ / ~J /
FOIL Ser. #:
DEFARTMIENT:
ASSESSOR ^
ACCOUNTING ~'
CODE, ENFORCEMENT ^
PLANNING ~-
TONING C.
FTRE INSPECTOR C:l
HIGHWAY ~ i
RECEIVF,.R OF TAXES l.:J
RECREATION I.-1
SUPERVISOR n
TOWN CL'FRK ^
WATER/SF,WER I i
DOG GONTRpL ()Ei~i.CER ^
TOWN ENGINEER
TOWN ATTORNEY CJ
2aog-10-16 JCM
TOWN OF WAFFINCJER
Application for Public Access to Records
Fort ~~~rEST
FOR DEPARTME~JT L?SE QN~Y
Date Received by Dept _ I _ I
Department Head approval:
(init)
Date Applicant Contacted: - l - ~
Date FOIL fulfilled denied: ~ / ~ / ~a'
Closed by:
pate: - ~ -- ~
Notes:
Amount Due: Pages or a total of $
Name: ,~±,~„ ., ~,,~~ C3 chick here if you are
Address: ^e~~/a[.tn,~0/~t) U/P~c~U /~d~ ~ requesting that the records
n. ~ ~- ~i q~ It'. t 1. /L.~. y / ~ ,~"'d ~ be mailed to this address.
Agency or firm:
Telephone #: (g ~ / 4 FAX #: ( ) "~ " --
Email address: _,_ /yam ~ ~a ! le r ~ a~l!.r_x~n~ ~ ~ ~~
OF RECD 11 I --~
FORMAT OF RECORD (if available)
G I request to be notified when i can came to inspect the record(s) described above
1 request copies of the records described above and ogee to pay the cost of such records in
accordance with the fee schedule on the back of this application
^ i requcst that the records be sent via a-mail to the address listed above
~.1 1 request that the records be faxed to the number listed above
1 ___
FROM :DUTCHESSKNOLLSINC FAX N0. :8457652075 Aug. 03 2012 12:OOPM P1
,~
I.A. CC] VET ,S~I~i ~+ T
Att. From:
FAX• Date•_„
Re: Phone : (845) 897-9636
PNON~
0 Urgent
.,., RepIyASAP '
~:~+ Please comment
.;: Please review
^ Foryourinforme~on
Total number of pages including the cover letter. ,
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