197FOR INTERNAL USE ONLY
Received by: Christine Fulton ^ /
Jessica Fulton
Date Received: ~/ ~ /
i
FOIL Ser. #:
DEPARTMENT:
ASSESSOR C~
ACCOUNTING ^
CODE ENFORCEMENT C~
PLA ^
ZONING
FI SPECTO
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 JCi
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~~/ ~~ /Z'
Department Head approval: .
(init)
Date Applicant Contacted: ~Z/ ~ g/
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Date FOI fulfilled denied: ~~' ~ /~~-
Closed by:
Date: jZ //~ /~
Notes: r ~U
Amount Due: Pages for a total of $
Name: ~ASc~N ~A~SS CYcheck here if you are
Address: I1 02og~ri'~ , 'L( sr .~olZ requesting that the records
N`~'~ ~ NY loo d 4 be mailed to this address.
Agency or firm: t=N'i~EGi-~- ~~N~~R~tiG-~ P. C .
Telephone #: (64b) ~ZZ - o00o FAX #: (z t Z,) ~- gvl 8
Email address: P kaS 5 ~ efv fP c~ -v ~ . co ro-
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SPECIFIC DESCRIPTION OF RECORD: PIe.~ ~~-~'~M~ L+z R~vEx..~D, ~LO~ ~~~ ~ ~'N~>
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FORMAT OF RECORD (if available)
4 _ I request to be notified when I can come to inspect the record(s) described above
~1 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