144FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton //~
Date Received: ~ /~/ /.1--
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 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ /~~ % 2
Department Head approval: -~
(init)
Date Applicant Contacted: ~ / eZ,S/ /~
Date F ful ill r denied: ~ /Z~/ /Z
Closed by: ~ G-'
~
Date: U~~~"'" ! / c7~ / / a.
Notes~~' ~~
Amount Due: Pages for a total of $
Name: `~c~\U ~C uK- ~~, ~ ~.:~r. ~ p= ~~,r,a ^ check here if you aze
Address: S~ o~ ~' i~ '~,~~ ~,, r"~ requesting that the records
~~"~"""~'t~ ~~ ~'~ ~~"° `"~ "~ ~'` t~ '~~`~ ~- be mailed to this address.
Agency or firm: ° 1~ ;~~. ,< t,~+''f ~.~ ~,
Telephone #: (~O 31) " 2~. - ~t~~ ~ AX #i: ( )
Email address: 1F-,s~ ~,~~aV~ is t.~vt~~ ~ ~..J~ r"t!~'Wrv.d'c~pw.
SPECIFIC D IE~CI~TI ~OF~yR~ECOR\D:
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