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026 Received by: Christine Fulton 0 Jessica Fulton :if: 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Date Received: ~/kL/0 rJ-AG FOIL Ser. #: DEPARTMENT: ASSESSOR D ACCOUNTING D~ CODE ENFORCEMENT ~ PLANNING . D ZONING D FIRE INSPECTOR D HIGHWAY D RECEIVER OF TAXES D RECREATION D SUPERVISOR D TOWN CLERK D WATER/SEWER D DOG CONTROL OFFICER D TOWN ENGINEER D TOWN ATTORNEY D FOR DEPARTMENT USE ONLY Date Received by Dept Department Head approval: / / (init) Date Applicant Contacted: / / Date FOIL fulfilled or denied: / Closed by: Date: / b / / :J-- --- Notes: 1]' /..e.IJ.) J2 . m 0 ~~ Amount Due: Pages for a total of $ o check here if you are requesting that the records be mailed to this address. )-- SPECIFIC DESCRIPTI?N OF RE~01ill: ft12'~~dCtQ\rt~.+ k..t ,;, ICJc; ') ~ /;)Ol~ ,'-I- wc,J 6u'(' (J- FORMAT OF RECORD (if available) o 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 D I request that therecordsoe-senfvlae-mill follie iiddfesslistedabove o I request that the records be faxed to the number listed above 6d67-0a-86/93~