047FOR 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
~qy ~~U~O
N~N~ p ®~~~,~
f7~~ pp~ ~R T
FOR DEPARTMENT USE ONLY
Date Received by Dept - / _ /
Department Head approval:
(init)
Date Applicant Contacted: _ / _ /
Date FOIL fulfilled or denied: - / /
Closed by:
Date: _ /as/ ~ 3
Notes:
Amount Due: Pages for a total of $
Name: ( 1 ^ check here if you are
Address: _.~,,~ requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: ($~) ~_-~~ F #: ($~rj) ~Z--
Email address: L~'PNG6SQ DPTpN11N~i~lET
SPECIFIC DESCRIPTION OF RECORD:., w
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