024FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton ^
Date Received: ~ / ~/
FOIL Ser. #: ~,~'
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY 0
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 ~ / ~/ ~
Department Head approval:
.)
Date Applicant Contacted: ~ /1~
Date FOIL fulfilled or denied: o~ / ~/~ ~3
Closed by:
Date: - /
Notes:
Amount Due: Pages for a total of $
Name: ' ^ check here if you aze
Address: requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (~y,~) Lj~ y- oo ~~ FAX #: ( ) -
Email address:
OF
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
D I request that the records be faxed to the number listed above