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167FOR INTERNAL USE ONLY Received by: Michael Leonard 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 ^ 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST RECEIVED DEC 2 7 2013 BUILDING DEPARTMENT TOWN OF WAPPINGER FOR DEPARTMENT USE ONLY ~ / 7 3 $~ Date Received by Dept Department Head approval: ~ ~ Date Applicant Contacted: ~(~/ ~~/ Date FOIL fulfilled or denied: l / ~ / Closed by: ~" ~~. ~ s ~ Date: 3a P _/_/ Notes ~~r 33/- ~~~ ~ ~---n Amount a total of $~~ ~=_ Name: _%dN~ G. /2,usl~ ^ check here if you are Address: Po fax 33s~ ; ZSS ~a~vc- ~"- requesting that the records ~ /NG , S7'~~ ~ N'7 I2yo~ be mailed to this address. Agency or firm: ~k ;~ l~A nLl~ b~ A L Telephone #: (~~15) .331 - yl oa FAX #: (~) ~3 r - 6930 Email address: ~i oH+~ G R~u-5 u- © RtvH I'j'f . Boni 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 ;v c~ie'