045
FOR INTERNAL USE ONLY
Received by: Christine Fulton ^ ~
Jessica Fulton .~
Date Received: ~/ ~ ~(/w
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 _ / _ /
Department Head approval: ((11
~JIjdO S,2i0SS3S56~'nit)
2i30RIIddH!~.n. ~n ~MOl
Date Applicant Contacted: _ / /
~! ii l ~ ~ s b~
Date FOIL fulfilled or denied: _ / _ /
~3E1I~~~2~
Closed by:
Date: _/_/
Notes:
Amount Due: Pages for a total of $ c
Name: L PLC (~~/~(5l~ 1 ^ check here if you are
Address(? ~"'1'~R ~ .~ ~ U D requesting that the records
-t ~' ~ ~ be mailed to this address.
Agency or firm: ~ S6 ~
Telephone #: b) - n FAX #: ( ) -
Email address:
SPECIFIC DESCRIP ION OF RECORD:
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 e-mail to the address listed above
^ I request that the records be faxed to the number listed above