070t~~~~~ ss ~ s'7
FOR INTERNAL USE ONLY
Received by:
Date Received:
FOIL Ser. #:
Christine Fulton
Jessica Fulton
l ~ l -ls-L
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORCEMENT '~
PLANNING ~
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
Name: ~f'SiEd~-T-' i U, ~ ~~L... ^ check here if you are
Address: ~.~ Y ~q~y I,~.I ~c.,r-t ~': ~ 'I~,~ O ~ requesting that the records
y'DUC.~ t+e~~-YES i (!/ M ~( I Z (~~i ~ be mailed to this address.
Agency or firm: TiNK.i>/~ih'11.1N ~'12.C~t-4'l1L.C.T2.1YL.~ l''~.;.r~_, .
Telephone #: (c3YS) ?'~ - ~~~ FAX #: (~,q'~) ~i~ ~ - c~ ~,~.
Email address: ~T~~^.~er _~_ i rt 1~c~„_cch <. c_-c~,~_
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / ~/ l
Department Head approval:
(init) j
Date Applicant Contacted: ~ / ~/ /.~ ,~/~ ~,?QL
Date FOIL fulfilled or denied: / /
Closed by: _
Date:
~Ql ~ ~ l f
Notes: Ir1t'~ t ~~ l--1~~F~G~~~ ~(~~
Amount Due: Pages for a total of $
SPECIFIC DESCRIPTION OF RECORD:
1~~~'~u-~i Tex I ~# i "3`~~Y~ -col S'7-c~ 2 - ~ S~ X05'7.
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~~~ I p I U I t~ i M• ~C.~M
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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~,~,p~>~~--~tG~~ ~~--
^ 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 C' (~ /~~~' l
^ 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