060FOR INTERNAL USE ONLY
Received by: Christine Fulton ^ J
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 0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
~tECEIVED
(JUN 0 3 20~~
PLANNING DEPARTMENT
TUWN OF VVAPPINGER
FOR DEPARTMENT USE ONLY
Date Received by Dept - / _ / _
Department Head approval:
(init)
Date Applicant Contacted: _ / _ /
Date FOIL fulfilled or denied: ~ / ~/ /
Closed by:
Date:
~pl l~l ~~
Notes:
Amount Due: Pages for a total of $
Name: ~,~( 1 _ D check here if you are
Address: requesting that the records
~'~~~ 2 be mailed to this address.
Agency or firm: i~P,11
Telephone #: ($4rj) _$~]_-a375 F #~ (BtIS) ~Z"~~-
Email address: L3'PHG6zQ DPT~NUIJ~ i`ET
DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the record(s) described above
D 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
D 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