136 (2)FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton X9,1
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 ~' / ~ / ~ ~--
Department Head approval:
(init)
Date Applicant Contacted: ~ / ~ / /~
Date FOIL fulfilled or denied: ~ //~ / / ~'
Closed by:
Date: / /
Notes:
Amount Due: Pages for a total of $
Name: /
Address: i
Agency or firm:
Telephone #: (s-~s) Zs~- ~5' ~ FAX #: ( ) -_
Email address: r ss-r.~. ~ ~. ,,,,~~~~„ /, ~, @ , h ~ ~
^ check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
~!~-~1~~~-/ ~S G~ K/iy~i~L I'Yl.`.~" f~rs w .v
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 e-mail to the address listed above
^ I request that the records be faxed to the number listed above