082FOR INTERNAL USE ONLY
Received by:
Date Received:
FOIL Ser. #:
Christine Fulton ^
Jessica Fulton! ~
/ !-1- / .~
~~
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
0
0
0
Name:
Address:
Agency or firm: Z.
Telephone #: (~c~
Email address:
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:
(init)
Date Applicant Contacted: ~/
Date FOIL fulfilled or denied: ~ /
Closed by:
Date: / /~_
/'1 /1 w ~- -~ _
Notes:
Amount Due: Pages for a
^ check here if you aze
requesting that the records
be mailed to this address.
FAX #: ( ) _
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 Iisted above
^ I request that the records be faxed to the number listed above