135FOR INTERNAL USE ONLY
Received by: Christine Fulton ^ i
Jessica Fulton ~/
Date Received: ~ / ~ /
FOIL Ser. #:
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT ^
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
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~ / / oZ
Department Head approval: ~~
(init)
Date Applicant Contacted: ~ / '~ / ~ ~
Date FO it or denied: ~ / ~ / ~ ~-
Closed by: / ~G-'
Date: n~ d ^'' .~- / / ~Z--
/V
N ~~'C
Notes: ~ r '
Amount Due: Pages for a total of $
Name: d~jNr4t.~ ~~I~sYL ^ check here if you are
Address: ~ rin i~ ~~a- requesting that the records
cla~c~cc- i~S~J- be mailed to this address.
Agency or firm:' ~ u ~~ ~.. J~Lt
Telephone #: ( S~) St gs - l~~s FAX #: ( ~) ~- 337
Email address: `~~! . ~'r1A-KJiL~ ~P...~ycr,~t~i~ac.S cs~tS ~ v o-H--
SPECIFIC DESCRIPTION OF RECORD:
~T"E7Z ~-T CJ .9- G "~ t ~~
a s ia-6a
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