098
FOR INTERNAL USE ONLY
Received by: Christine Fulton
Jessica Fulton
Date Received: ~ /~~~
FOIL Ser. #: ~~
DEPARTMENT:
ASSESSOR L7
ACCOUNTING ^
CODE ENFORCEMENT C~`'
PLANNING ^
ZONING ^
FIRE INSPECTOR ^
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK ^
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR DEPARTMENT USE ONLY
Date Received by Dept ~ /.>v /
Closed by: ~~~"
Department Head approval: ~G-
(init)
Date Applicant Contacted: ~ /3U / ~-~
Date FOI fulfilled o denied: ~ / 3 U //~
Date: ~ / ~ / 3~~ /~.:~
Notes:
Amount Due: Pages for a total of $
Name: l~ 1 C. 6
Address: lll9 tt-~ ~(:
Agency or firm:
Telephone #:
Email address:
~~)
^ check here if you are
requesting that the records
I?.~ 3..7 be mailed to this address.
FAX #: ) -~~~
SPECIFIC DESCRIPT ON OF RECORD:
~! / ~
FORMAT OF RECORD (if available)
C~ I request to be notified when I can come to inspect the record(s) described above
1 ! 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 e-mail to the address listed above
I request that the records be faxed to the number listed above