052FOR INTERI\'AL USE ONLY
Received by: Christine Fulton
Jessica Fulton
Date Received: ~ / o~ /
FOIL Ser. #: ~a~_
DEPARTMENT:
-
SSESSOR -
ACCOUNTING ^
ENT
CODE ENFORCEM
_
PLANNING
ZONING ~~
FIRE INSPECTOR
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR Cl
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 5~ / .~ ~ / ( ~
Department Head approval:
(init)
Date Applicant Contacted: ~ / ~a/ 13
C~ j~,~ Q M^GS~ge S'30 (3. o -'CS~nSt SinCt
Date FOIL fulfilled or denied: - / _ / '
Closed by:
~~
Date: (~ ~ ~ ~Il 3 `-~ ,./ ~.---(~--,
Gt~p1 i`ca~ ~.-me ~~n t~/~ s/~ 3 . ~ v
Notes:
F ha ~ fJrr
Amount Due: -- Pages for a total of $
Naive:
Address:
^ check here if you are
requesting that the records
be mailed to this address.
Agency or firm: ~:-~~:~ 1' ~-~-~~~
Telephone #: (~j73) `~ S~- - ~~~ FAX #: (`{73) ~1~ - 2~/~'
Email address:._.~~`.yQ'~ ~~n.~?~l~~±na ; ..,~'~-~:I.~.~T.. ,...
SP~CIFIC DESCRIPTION OF RECORD:
~.iz5~ %~`~•!E~1.2 ~~t~: a~~ ~l ~v~~~r~w~-e~ ~ ~cum~r~~~l~~~~ s~.:.h c~5 S r~E'~,r`~'~ ,
t1C~ "r^ r` tC:~ ~ (,~- ~d~t`' rau .~`r.~{~: t k' , ~. ~,1~~~~ ,~.... ~~ ~~
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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~ I request that the records be sent via e-mail to the address listed above
T request that the records be faxed to the number listed above
~~.
FOR INTERNAL USE ONLY
Received by: Christine Fulton
Jessica Fulton
Date Received: ,~,_ / a~ /
FOIL. Ser. #: ~o~_
DEPARTMENT:
SSOR
SSE
_
ACCOUNTING ^
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR Cl
TOWN CLERK ,
~J
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER
TOWN ATTORNEY
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FDIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept 5~ / .~ 0 / ( ~
Department Head approval:
(init)
Date Applicant Contacted: / a/
C~ ~~'f"r d- M•CSjC~ge 5130 /3• ~O rCS~nSt SinCf
Date FOIL fulfilled or denied: - / _ /
Closed by: 1~ IQ-r~'
Date: ~ / ~ / I3
Notes:
Amount Due: Pages for a total of $
Natne: KYtt~t 1
Address: :~-~7 I ~ E~'~
~ ~ rn r
Agency or firm: ~-{p~.~-r,1~ rx
Telephone #: (~j73) ,~-
Email address ~ya~ f~xtt~.s~~
^ check here if you are
requesting that the records
be mailed to this address.
FAX#: (~73) ~~~~- - 2~/~'
SP °CIFIC DESCRIPTION OF RECORD: /
~~~~ t? Ri`o' r€ f~'~ ~~~ lt-'l c~ ~ ~I V i (Ord ~1-Fdl CtoCcl N7 ~i~a_`/~c,~~' St,(~' h rt5 ~~:~~~''~
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~L ~xri ~z~,•, ' ~ {~ow,rr ~~ t'~ r1. -• Ufa fit` S' w:. i~{`~.r'r~I~4,
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?r I request that the records be sent via a-mail to the address listed above
I request that the records be faxed to the number listed above
~~.