011.r•
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FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton ~
Date Received: ~ /~ /
FOIL Ser. #: ~~
DEPARTMENT:
~C
ASSESSOR ^
l~
~
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 t / 3 ~ / dui 3
Department Head approval: '
(init)
Date Applicant Contacted: _ / - /
Date FOIL fulfilled or denied: ~ / 1 / 2 0 ~ -5
Closed by: ~~Q~~~~S
Date: ~ / 1 / Zvi 3
Notes: C,h~~.~~, t -fie L i ~~ ~?~~~ '~
Amount Due: Pages for a total of $.
Name:
Address:
^ check here if you aze
requesting that the records
be mailed to this address.
Agency or firm: "
Telephone #: ($'~ _- FAX #: (g~{$')'~j -s~~/
Email address:
SPE ~~I~ ~ RIPTIO OF CORD:
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