015FOR INTERNAL USE ONLY
Received by: Christine Fulton
Jessica Fulton ^
Date Received: ~~ ~ l ~~l l 3
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 #: ) -.
Email address:
SPECIFIC DESCRIPTION OF RECORD:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~ / / 3
Department Head approval:
(init)
Date Applicant Contacted: - / _ /
Date FOIL fulfilled or denied: _ / /
Closed by: '~
Date: - / .- /
Notes: _~_
VYI~
Amount Due: ages for a total of $
^ check here if you are
requesting that the records
be mailed to this address.
FAX #: (~~ ) ~~- ~O'~ I
u,-c c.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 a-mail to the address listed above
L~j I request that the records be faxed to the number listed above