077Pr~~~ s~ ~ ~5~
FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton "~
Date Received: ~ ! ~ /
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNIN _
~
ZONING ~
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER
TOWN ATTORNEY 'J
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ / /~ /
Department Head approval: _~(G-
(init)
Date Applicant Contacted: ~ /~~ / ~ ~
--
Date F L fulfilled denied: / ~ /
Closed by:
~~.
Date: ~ / / / ~
5
Notes: ~ ~a~ Z ` l
Amount Due: Pages for a total of $
Name:
Address:
check here if you are
requesting that the records
be mailed to this address.
Agency or firm: ~i n Ic,Et~ v-~~t~ f~'2.~ ~ T~-E~U14~ -"~-i•.~ .
Telephone #: (Qj~~) ~3 - 0~ FAX #: (8y S) ~_-~Z•
Email address: C~~U rr1 ~.~r-~'G j vl k-~~'c.h • ~=c
SPECIFIC DESCRIPTION OF RECORD: ~
~ M . ~ ~ ~ ~t-i i
(~ ~~ rntrJlnc~tS
.
~ ( ~ ~ M, 2+ ~'I`l
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