057FUR 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 ^
S RVISOR ^
TOWN CLE
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER
TOWN ATTORNEY ~-l
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FDIL REQUEST
FOR DEPARTMENT USE ONLY.
Date Received by Dept ~ /~/ / 3
Department Head approval:
(init)
Date Applicant Contacted: ____ / ____ /
Date FOIL fulfilled de : ~ ~~ / ~ ~
Closed by: '~
Date:
,~/i3
Notes: ~ i ~ ,
__
Amount Due: Pages foz a total of $
Name:
Address:
Agency or firm: /~~.~-r;1, .1``'~cr
Telephone #: (973) ~t~ -
Email address nfl!a., ~,
^ check here if you are
requesting that the records
be mailed to this address.
FAX #: (273) ~t2 _ 2~/~'
SP -C'IFiC DESCRIPTION OF RECORD: -
~~~cSe '~, ~ ~~rQ ~~. ~~ ~1 ~)vi(ar~~~C>y( r,~cum~r~a_~1;~r, S~tc'h ~s ,~"t~f'~~'~
r`l~ "}' : " ~~ . r C't' (,~t. ~dt? r roU .5 Ott- e, C {~ 2: ,;,~'i• • ~~ ~:a °~t
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L. tl~~~ ~ ~ ipWtV} ~G: L1 ~'" ~~ 4( {+ YJ~i " J.9'"~.~ /'~.t~5~
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 he sent via a-mail to the address listed above
I request that the records be faxed to the number listed above
~~.