029RECE~ VED
FOR INTERNAL USE ONLY
Received by: Christine Fulton y~
Jessica Fulton 0
Date Received: ~ / ~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 ^
Mti;} v ~ ~ ~ 2009-10-16 JCM
BUILDINGDE~ ,,,~~ OF WAPPINGER
TOWN OF
~'~'~n~'tion for Public Access to Records
FOIL REQUEST
RECEIVED ~~
MAC:' :~ ~y3 c~i~'F
BUILDING DEPARTMENT
TOWN OF WAPPINGER
>>3
~Cti
2,q AN~FNT
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~ / /3
Department Head approval: /~~
(init)
Date Applicant Contacted: 3 / ~ / /
Date FOI fulfilled r denied: ~ / / ~ /
Closed by: ~ 9
Date:
/ /
Notes:
Amount Due: / Pages for a total of $ 3.5~
Name: ~/1/~Gl-6 ~~-~-~ C check here if you are
Address: ~j n/G ~1n Al E ,~ 5 ~ X10 requesting that the records
VDU G N kE6PS) ~ 0 be mailed to this address.
Agency or fine: Z~ ~ ~L.C- C
Telephone #: (g~ ~) y5U - .~ FAX #: ( ) -
Email address:
SPECIFIC DESCRIPTION OF RECORD:
02~ - C~C~
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(~aS~-o/- 3s''~ z~
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
G I request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above