158FOR INTERNAL USE ONLY
Received by: Christine Fulton °~l
Jessica Fulton ^
Date Received: l ~ / '~ / ~ 01 '
FOIL Ser. #: 1 ~~
DEPARTMENT:
ASSESSOR
ACCOUNTING ^
CODE ENFORCEMENT ^
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER 0
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: N~1„~}-
(init)
Date Applicant Contacted: _ / _ /
Date FOIL fulfilled or denied: ~ / ~ / L~
Closed by: /J R,A-
Date: ~2 / ~ / I ~--
Notes:
Amount Due: ~ Pages for a total of $ I -yo
Name: ~~_~ ~~I-2 2 ~= L ~- ^ check here if you are
Address: JC t~ ~u 2Gz~S R 0 requesting that the records
/D2l<Tow-,'~ H-~ S ..~~ loS9~ be mailed to this address.
Agency or firm: (3~-r~rL t{~sY•n~ c ~~+~~s R-Prr~~ R~=~~~
Telephone #: ~t i ~t ) 40(0 - ~ a.~ ~ FAX #: (`1 i ~) ~ ~ ~- - ~ a-3 9
Email address: n1b2~-z~ , SPA-2rzcZ~e 2P~~ d2~~-t-y
SPtt~E,,CIFIC DESCRIPTION OF_RECORD:
r~`nC~'~'L GA-21J5 ~cs2 7'~ C~Xp R-i~ A-(~P~NC~-n.~ 6-Pry-~ ~
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