0462009-10-16 JCM
FOR INTERNAL USE ONLY
Received by: Christine Fulton ^ ,
Jessica Fulton
~ (t'~ 13
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 ^
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept _ / _ /
Department Head approval:
(init)
Date Applicant Contacted:
~OId~O S~~~
b JNI 'ddM d0 NMOl
Date FOIL fulfilled or ~eme~: _ / _ /
Closed by: £lOZ ~/ ~ ~~
Date: ®3~I~~,~2~/
Notes:
Amount Due: ~7~-Pages for a total of $
Name: 'fi/`vZ- °LG f~i~S ~ t, ^ check here if you are
Address: ~` d~ ~ j ~ `e ?~ requesting that the records
,AY.{ 7 Jt ~ ~ be mailed to this address.
Agency or firm: ~.~ TL I~ s
Telephone #: ( ~ ~) ~~ - FAX #: ( ) -
Email address:
SPECIFIC DESC PTION OF RECORD:
FORMAT OF RECORD (if available)
^ I request to be notified when I can come to inspect the records} 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
2009-10-16 JCM
FOR INTERNAL USE ONLY
Received by:
Date Received:
FOIL Ser. #:
Christine Fulton ^,
Jessica Fulton
~/ ~•'/~
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~ 5 / ~
Department Head approval:
(init)
Date Applicant Contacted: 5 b~C7 / / 3
Date FOIL fulfilled or denied: 5 /~U / I ~
Closed by:
Date:
~ / l~
Notes: ~D ,f -'~~cP-~'n/~~.115'4~-' ~--l~x~--
Amount Due: Pages for a total of $
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 #: (~~~) - FAX #: ( ) _
Email address:
^ check here if you are
requesting that the records
be mailed to this address.
FORMAT OF RECORD (if available)
~1 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