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00501/17/2013 12:34 8456917229 PROFESSIONAL SPEECH PAGE 02
FOR INTERN L LJSE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: ~ /~ /
FOIL Scr. #:
' DEP,A-RTM.ENT:
ASSESSOR ^
ACCOUNTING i]
CODE ENFORCEMENT fJ
P.1/ANNTIVG ^
ZONING U
FIRE INSPECTOR C]
I~iIGHWAY
RECEIVER OF TAXES IJ
RECREATION U
SUPERVISOR. (~
TOWN CLERK
WATER/SEWER []
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEX 0
Name:
Address:
2009-10-16 JCM
TO'V4~ OF WAPPINGER
Application for Public Access to Reeords
FOIL R,EQU~ST
RECEIVED
JAN 17 2013
DEPARTMENT
FOR DE TMENT USE Y
Date Received by Dept ~ / ~~ „~ j
Department Head approval:
(init)
Date Applicant Contacted: ~ / ~~~
Date FOIlr fulfilled or denied: ~ /~
Closed by:
Date: ~/ ~~
Notes: ~ )~ n( ,~,101~- ~~- ,~~ ,. i~~D~
Amount Due: Pages for a total. of $
l~ check here if you arc
requesting that the records
be mailed to this address.
Agency yr firm:
Telephone #: (B~Y,r-) ~~ F.AX #: ( )
Email address:~E _CE~ O ~T'0 N L/ N~, tiE i
SPECIFIC DESCRIPTION OF RECORD: G
~ `7 3 _ ~u~l-e 9 1~
FORMAT OF RECORD (if available)
^ 1 request to be notifed when I can come to inspect the record(s) described above
^ J request copies of the records deacribcd above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
J~' 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
