074
Prr~m~ ~~s~ ~~ 5
2009-10-16 JCM
FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: ~Q / '~ /
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 ^
Agency or firm: Ti n K-i~l..yy~A t~ I~.~ -+~ ~E-F.~ttl~- (~ i~-~-
Telephone #: (Y~~'S) 4l 3 - ~b FAX #: (by ~) 4~'~ - u ZGs"? .
Email address: 1'• iU,^ncr~~_ in~.a.r'~1~__~C.t.~m--
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL .REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / I ~ / ~
Department Head approval:
(init)
Date Applicant Contacted:
Date FOI fulfilled o denied:
Closed by:
Date:
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Notes: C-d~ ' a
Amount Due: Pages for a total of $ Z • L
Name: ~„~¢.~LTT~[ 12M ~2. ^ check here if you are
Address: ~ ~ ~.~. requesting that the records
~ E 2 ~„~ 3 be mailed to this address.
DESCRIPTION OF RECORD: _
~,,~ rpm ((~~ 13 S'6b°(- (mot 5~ ~-02 - 58~ ~~i
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
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