091FOR INTERNAL USE ONLY
Received by: Christine Fulton ^
Jessica Fulton
Date Received: ~ / ~/
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
Name:
Address:
0
0
0
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~/ ~ / J
Department Head approval: ~"
(init)
Date Applicant Contacted: _~ / 2,._ /
Date FO fulfilled~r denied: ?/ 1„r / f
~~
Closed by:
Date: ~/~~
Notes: i~r~. , ~~ ~,.,, ,
Amount Due:,Pages for a total of $
Agency or firm:
Telephone #: S) ~~-i3..~~U FAX #: ( ) _
Email address: ~~n i C ~ ~Dy1~'l /~ r'~ ~l
^ check here if you aze
requesting that the records
be mailed to this address.
!Y~2~I , ~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
SPECIFIC DESCRIPTION OF RECORD