172FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton ~'
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 ^
Name:
Address:
Agency or firm: (~
Telephone #: ( 1~ )
Email address:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~ / 1
Department Head approval:
(init)
Date Applicant Contacted: / /
Date FOIL fulfilled or denied: / /
Closed by: ~ ~~
Date: /1/~/L_~
Notes:
Amount Due: _~ pages for a total of $ p . `>
~ ^ check here if you are
requesting that the records
be mailed to this address.
~ S,y.-~ ~
FAX #: ( ) _ ~'~
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