085JUN-21-2013 21:30 FROM:
FOR 1NTER.IJAL USE ONLY
Received by: Christine Fulton O/
Jessic//a~~Fulton ~-
.Date Received: ~ ac~o ~
FOiL Ser, #:
DEPARTMENT:
ASSESSOR ^
ACCOUNTING ^
CODE ENFORGEM.GNT l~
PLAN'N1NG ~
ZONING ~
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES C]
RECREATION U
SUPERVISOR (J
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER Cl
TOWN ENGINEER ^
TOWN ATTORNEY ^
T0: 92970579 P.2~9
rrc~t.~c.x~ 5`II(c~~
2009.10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
1G'OIL REQUEST
FOR DEPARTME USE ONLY
NT
Date Received by Dept /
(~ / ~/ ~
Department Head approval: ~
(init)
Date Applicant Contacted: ~ / ~ / ~
Date FOI fulfill r denied: ~ / l / ~~
Closed by, ~
Date; ~/ ! / ~ -~'
Notes:
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: J t n ti, ~wi~rr ?ter?' ~ Q ~ - u.~.. .
Telephone tf: (t?,N5') ~_- 0 FAX /t: ($y ,~j ~~- O?.W7•
Email address: .~Tu.r_cLr~ d _I_h ~0~!^4.h ,.<,t~~'w
sP clFic D>rscRYPTIoN of RECORD:
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FORMAT OF RECORD (if available)
~ 1 request to be notified when I can come to inspect the record(s) described above
^ 1 request copies of the records described above and agree to pay the cost of such records in
accordance with ibe fee schedule on the back of this application
U 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