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016 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Received by: Christine Fulton D/ Jessica Fulton .a$ Date Received: -L I'di:) .J!:b. FOIL Ser. #: Q\ ~ DEPARTMENT: ASSESSOR ACCOUNTING CODE ENFORCEMENT PLANNING ZONING FIRE INSPECTOR HIGHWAY RECEIVER OF TAXES RECREATION SUPERVISOR TOWN CLERK WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 o o o o o o o o o V FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: I I (init) Date Applicant Contacted: 1.- I ~ a Date FOIL fulfilled or denied: L;Jt.Y 12 Closed by: ~$;i~ Date: -L I ~ I Kl. Notes: Amount Due: Pages for a total of $ Ad~:=' 11?~~1r~tLS;Alr Agency or firm: e Telephone #: (81.fS'") ~-13~#-. FAX #: ( )_- Email address: D check here if you are requesting that the records be mailed to this address. SPECIFIC DESCRIPTION OF RECORDm ' t . 1 n I.L (!!,.s 9~, of 0a\1u..~~ijtfl~ FORMAT OF RECORD (if available) D I request to be notified when I can come to inspect the record(s) described above o 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 o I request that the records be sent via e-mail to the address listed above o I request that the records be faxed to the number listed above