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93FOR INTERNAL USE ONLY Received by: Christine Fulton .~ Jessica Fulton ^ Date Received: FOIL Ser. #: CP / ~ ~ / 12r c~ a'~ DEPARTMENT: ASSESSOR ACCOUNTING 0 CODE ENFORCEMENT ^ r FIRE INSPECTOR ^ HIGHWAY ^ RECEIVER OF TAXES L~' RECREATION ^ SUPERVISOR ^ TOWN CLERK ^ WATER/SEWER DOG CONTROL OFFICER ^ TOWN ENGINEER , L7 TOWN ATTORNEY 0 2009-10-16 JCM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR DEPARTMENT USE ONLY Date Received by Dept ~ /~ g / / Z Department Head approval: ~~ ~~ ^ h~/ (init) (V U . Date Applicant Contacted: _ / _ / _ Date FOIL fulfilled or denied Closed by: Date: . ~/~~/~Z ~- " ~( . ~p l~~l /z. Notes: Amount Due: Pages for a total of $ Name: ~ i~ ~l'(~~-t.~ i ~' ^ check here if you are Address: ~ >2 requesting that the records d be mailed to this address. Agency or fum: JU,p Q Sdn) ~~'~ C ~~~,~, Telephone #: ( <<-() /~ ~3 FAX #: (~l ~) 77- Email address: G> i'cJ o ~ i ' . Cdyl.~ SPECIFIC DESCRIPTION OF RECORD: S~Sn~ ~r JQ d~ C ,~-~v ~ of l ~ ~ v/ '~ ~ ~ ~ ~ S n 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 ti~ I request that the records be sent via e-mail to the address listed above ^ I request that the records be faxed to the number listed above FOR INTERNAL USE ONLY Received by: Christine Fulton ,~j Jessica Fulton ^ Date Received: FOIL Ser. #: CP /fit ~ / t ?s q DEPARTMENT: ASSESSOR ACCOUNTING CODE ENFORCEMENT ^ , FIRE INSPECTOR ^ HIGHWAY ^^ RECENER OF TAXES ly' RECREATION ^ SUPERVISOR ^ TOWN CLERK ^ WATER/SEWER f~" DOG CONTROL OFFICER ^ TOWN ENGIl~TEER TOWN ATTORNEY ^ Name: ~ /~i.~ ,f31' Address: 3 ~ 6 d2 L,' Agency or firm:.j(1"p 0 SG Telephone #: ( < <O IZr ~3. " Email address: ~,b lruhon~, i ~ SPECIFIC DESCRIPTION OF RECORD: T.4 tiD~~ . i~SL3Srvr ~/7-- 2009-10-16 JCM TOWN OF WAPPINGER Application for "Public Access to Records FOIL 1~EQ VEST ,, , FOR DEPARTMENT'USE ONLY Date Received by Dept _ / _ / _ Department Head approval: (init) Date Applicant Contacted: _ / - / Date FOIL fulfilled or denied: / / Closed by: Date: ~ / Z/ r Z Notes: ~o t Due: ~ r ~ _ d ~ ~ 1~~7 FAX #: (~l ) .i~ _~ _. _ Pages for a total of $_ . ^ check here if you aze requesting that the records be mailed to this address. Cg'y~-~ FO/RMAT OF' RECORD (if available) L7 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 4~ I request that the records be sent via e-mail to the address listed above ^ I request that the records be faxed to the number listed above