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024 Received by: Christine Fulton 0 Jessica Fulton K 9).. I~ 11.2:- 1f:-. 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Date Received: FOIL Ser. #: ~ WAPI> ~..~. ,...,~-:,.~~ ~ / . < - ~ ,,~' ,0. ".A\ I- . \'"' o . . i> c~~/~ "C:' . j .l..: ''Ye-'c ./~A... 5s co~ DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT :iT PLANNING 0 . ZONING 0 FIRE INSPECTOR 0 illGHWAY 0 RECEIVER OF TAXES 0 RECREATION 0 SUPERVISOR 0 TOWN CLERK 0 WATER/SEWER 0 DOG CONTROL OFFICER 0 TOWN ENGINEER 0 TOWN ATTORNEY 0 FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: / / Date Applicant Contacted: (init) 1 / --- Date FOIL fulfilled or denied:~ I Closed by: Date: -# c2 1,9 I /c2 Notes: O~ JlM}I..e.uJJ Amount Due: _ Pages for a total of $ Name: Address: o check here if you are requesting that the records be mailed to this address. )-- SPECIFIC DESCRIPTION O[ RECORD: -n (0. .:IA r~,^('r.; 5 +0 ('Or/r ('V\u.. ~ ,\ ~ P-Or-ch ~r Pore"'- OlrJ 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 . 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