180FOR 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 ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~,v/
Department Head approval:
(init)
Date Applicant Contacted: - / /
Date FOIL fulfilled or denied: / /
Closed by: ,,) p,A
Date: i I / ~ / 1 a--
Notes:
Amount Due: ~ Pages for a total of $ 0. ~ y
Name: ~ ~ t~0 ~- C. (-~~~ ~~ t ^ check here if you are
Address: ~ y ~~-tt.~ ~- a~n~ ~: ..1~~~. requesting that the records
~' OLD" p`~"~ be mailed to this address.
Agency or firm: ~'b2-d~1 `~ `~' f ~•S `~ "~ ~-"
Telephone #: (~~ ~) -1 ~3 - (7 j 1 ~ FAX #: ( ) -
Email address:~~{~b~C~ Fib=`[ r( ~~r~l~ ! . /~(~ T-
SPECIFIC DESCRIPTION OF RECORD•
~'iryE .. L' `E' s .. L 4; L ~ S U
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