152FOR INTERNAL USE ONLY
Received by:
Date Received:
FOIL Ser. #:
Christine Fulton ^
Jessica Fulton ^
/~/~
o~
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ~
CODE ENFORCEMENT O
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ~
TOWN CLERK ~
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 3CM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ /a~ / ~ ~
Department Head approval:
(init)
Date Applicant Contacted: \ / a.`6 / ~~-
Date FOIL fulfilled or denied: ~~ / ~ / ~1-
Closed by:
Date: ~~ / ~ / ~~
Notes:
Amount Due: a.~ Pages for a total of $ - ~
Name: C N RQ C.~S DA 1/'~a16' 0 2 i
Address: 3~_t~ ~L PI N~ ~D~Z ~ / r
Agency or firm: S ~ L. ~
Telephone #: (~ys) J~D - ~ o FAX #: ( ) _
Email address: ~ A L ~ Y ~ i9 xi! M ~ ~14.f~oo • G aM
SPECIFIC DESCRIPTION OF RECORD:
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~{ -u~ ~IIANG rivL / JL
^ check here if you are
requesting that the records
be mailed to this address.
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TOU)U c9 D s v~57~~
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FORMAT OF RECORD (if available}
C~ I request to be notified when i can come to inspect the records} 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