053FOR INTERNAL USE ONLY
Received by: Christine Fulton
Jessica Fulton
Date Received: ,~, / ~!
FOII. Ser. #: ~~~
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL RFQ UEST
FOR DEPARTMENT USE ONLY.
Date Received by Dept ~ / ~ /
Department Head approval:
(init)
Date Applicant Contacted: ~ / ~ ~/ !~
Date FO fulfilled o~denied: ~ /l( / / ~
Closed by: ~ ~"
Date: r
Jn~! 0
Notes:
Amount Due: Pages for a total of $
DEPARTMENT:
ASSESSOR
A O TIN ^
CODE ENFORCEMENT _
PLANN
ZONING
FIRE INSPECTOR
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK
WATER/SEWER ^
DOG CONTROL OFFICER 0
TOWN ENGINEER
TOWN ATTORNEY
Name:
Address:
Agency or firm:
Telephone #: (~73 }
Email address: _.,fYa~_.
^ check here if you are
requesting that the records
be mailed to this address.
- ~.~~? FAX #: (R73) '~~~~ - 2~l~'
SP~CIFIC DESCRIPTION OF RECORD:
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1~, ,~r t i C~ ~ ' (;~ +~G(f c~u .S~ L. f~c. ~, ' E k' ~. ~'i•~~ r~.... ~a ~~
~ ~"c+rtirl ~~ - ", $ ~ ~~"iorl G{,1'1 ~ ~ L:crtS'~~tC~r~~r1
~/ L i+l~fCF~ W 717 ~ c
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 a-mail to the address listed above
I request that the records be faxed to the number listed above
~~.