063FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: ~ / ~ / _l~
FOIL Ser. #:
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
RECEI~iFLy
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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:
b~C ~ F~oc~k-,Address:
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Agency or firm:
Telephone #:
Email address:
~~ )50~' _ rS77 FAX#: ~Hy )
^ check here if you are
requesting that the records
be mailed to this address.
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SPECIFIC DE CRIP ION OF RECORD: ,l ~ ]
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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 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
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~? / ~3
Department Head approval: /t!~'
~ a : 3 0 (init)
Date Applicant Contacted:
Date FO fulfilled or enied:
Closed by:
Date:
Notes:
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Amount Due: Pages for a total of $
TOWN OF'~VAPPINGER