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062 FOR INTERNAL USE ONLY 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST Christine Fulton (i{ Jessica Fulton 0 Date Received: 04 / /0/ I?- FOIL Ser. #: 0 Lo I Received by: ~ w~Pp ./'~..' .... ~~. ."~~- .~.~~.t,. :s:.. .. - ,".I>. ; .(f;/ . ',.. 0\"1:1' 'II- ;. \.... ..i~i>l ".o.......~...,.1 . c. .)~. :.A \ ' .A." C'. '. / A" / .+~."'._<\.+ .~.~ cO'" DEPARTMENT: ASSESSOR 0 ACCOUNTING 0 CODE ENFORCEMENT ~ 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 FOR DEPARTMENT USE ONLY -1 /~/r1- .~ (init) Date Applicant Contacted: d / I 0 / ( L- DateFO~enied: -1/ltJ / / L- Closed by: q 6- Date: ::L. / / () / / 2- Notes: ~ Co~ ::: tr.z s-- . Date Received by Dept Department Head approval: Name: rz:iL Address: ~ ~ ~P'l.se J",,~ I~f((;~ijr~~;~l A/'y loICCJI Agency or firm: h~ Telephone#: (<?fr)~ - /9'('1 FAX#: ( Email a.ddre$s: Amount Due: Pages for a total of $ o check here if you are requesting that the records be mailed to this address. )-- 5f ecA (~e ilr FORMAT OF RECORD (if available) o 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