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FOIL 55 Received by: Christine Fulton "F/.. Jessica Fulton 0 2009-] 0-16 .rCM TOWN ,OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Date Received: l/~ I ? FOIL Ser. #: tJ 5S ..' WA .~ o~':-!~'4: "~.."~'."~"~'CA' '0' ".". :.... ' . 'P O"~!,> c;.: l'S'""W'~'T/.1;C': ,~.,: (. "" .' ..... -srI'> . '''' .../,.",.4... <<:ssco~"'" . (init) DEPARTMENT: ASSESSOR 0 ACCOUNTmG 0 CODE ENFORCEMENT 0 PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK ]l{ WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 FOR DEPARIMENT USE ONLY Date Received by Dept Department Head approval: 1 1 Name: Al\/C Ie.. .E.OYEi?mYLI~ Address: 1n7~ KovfE q, {'vi/41./ F;S~f:., Jl /I! tj I :J!!.:J 4 Agency or firm: ~ F Telephone #: ('1''1 ) t/$':J - tOl3FAX #: (<;nl ).2iL.- 3'/ll:. Email address: L . IE J/.d.rfh"111 l'orJ!'l Date Applicant Contacted: _I _I _ Date FOIL fulfilled orB 2J~ I'd- Closed by: @ Date: 3.J6&/ I'd . Notes: t.m~J (fJO ROLOli',J3) ./ ./' Amount Due: .,L. Pages. for a total of $ ~ o check here if you are requesting that the records be mailed to this address, SPECIFIC DESCRIPTION OF RECORD: '~e- Br~jZ:~ ~~.. ~u ~rlTc.I4U'1? ~I inll"l,cFc (o('ckd tJn 'i/l';,.t.l/)~ 1"7 /Ut&f2l'l'ZftG\ li2llr. FORMAT OF RECORD (if available) o I request to be notified when r can come to inspect the record(s) described above C I request copies ofthe 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 o Trequest that the records be faxed to the number listed above