017FOR 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 ~ / ~ / / 3
Department Head approval: '
(
Date Applicant Contacted:
Date FOI fille r denied:
Closed by:
2/G//~
?~I~ l~J~
~ ll-'
Date: Z /~o / /,3
Notes: ~ ~d ~e
Amount Due: Pages for a total of $
Name: ~ -e ~(le. ^ check here if you aze
Address: ~S W eS t2e O~VC l ~{le. requesting that the records
Whi 1-e ~1~i'nS~ IV `~ lC)loC~~ be mailed to this address.
Agency or firm: ~,~(~ ASSeSS fY1~Cl~ S~+(UiC,eS ZY1C
Telephone #: (q t ~i) 3! lD -_ Q4~~~ FAX #: (0-t~{) ~- ~.{loscl
Email address: arle ~ 1V ~ - i~ll-41 ~ Cc}Y11
SPECIFIC DESCRIPTION OF RECORD:
/S -0 - O
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