162FOR INTERNAL USE ONLY
Received by: Christine Fulton '~
Jessica Fulton ^
Date Received: ~ ~ / `~ / ~ ~"
FOIL Ser. #: l C12 ~-
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:
~o / 5 / ~ a-
(init)
Date Applicant Contacted
~ / ~/ ~ ~
Date FOIL lfille or denied: ~ v / ,~ / l ~
Closed by:
Date: ~~/ ~ / ~~
Notes: ~~ ~ G'(.C-~
Amount Due: Pages for a total of $
Name: vr%~ ~~ 2j~-- ^ check here if you are
Address: i/6 ~~~ 4S~ '~ requesting that the records
C-,g- G/~i~~,~~/~L~e ~ ,cJ y~ , 2.S'yo be mailed to this address.
~--~
Agency or firm:
Telephone #: (~5~~ 2U(~ - FAX #: ( ) -
Email address: PL t-ICla~ .+s ~~ ~' -tf k~ L e Cam
SPECIFIC DESCRIPTION OF RECORD:
Zo / 3 r3v a C~~"i ~~o2I~S/~~%'S
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