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047 FOIL Ser. #: Christine Fulton ~/ Jessica Fulton p ~/!1IJQ L(J 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR INTERNAL USE ONLY Received by: DEP ARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT 1tl- PLANNING 0 ZONING 0 FIRE INSPECTOR 0 HIGHWAY 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 Date Received: FOR DEP AR TMENT USE ONL Y Date Received by Dept Department Head approval: 3ILI/;}.. ~fm Date Applicant Contacted: c3 I l!L I I ;z, Date FOIL fulfil1e~ _ I _ I _ Closed by: ..j3/C Date: 3 I ffl 1b0 Notes: it: SPEC /1"', i: - CA"'NO r ~ 0 _AI J.te-r '1< eP()~/S ' Amount Due: Pages for a total of $ Name: /Yl'- c J, 4. eL D I j)/ 5 (\ -:PI I~ 0 check here if you are Address: 17 'it; S t' c:.~ 'r-A. R cL requesting that the records p /y v,S Ii k t? e f) f;,~e .v t' I J...6 tJ I be mail ed to this address. Agency or firm: f/cJ/di- tAlAJ . t:lj),..es,~ Telephone#: (~4S) 4T~ - l/~-I/ FAX#: ('INS- ) 4S'') - &-/~T Email address: M ,', StL H:L t= ~ r? ~ ~ · . c.lit)t1. ( () A1 SPECIFIC DESCRIPTION OF RECORD: (oM/'II.e~"(.t'c.. ( CON:' (f\()c'i,O'1l fJ-PlI'lYl, '16 -( " t^ 'r It e [' k "'5 {- t.I pel p'\ ~~~ FORMAT OF RECORD (if available) D I request to be notified when I can come to inspect the record(s) described above D 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 e-mail to the address listed above J I request that the records be faxed to the number listed above