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088JUN-21-2013 21:33 FROM: FOR INTERNAL USE ONLY Received by: Christine Fulton L7 Jessica Fulton Date Received; ~ ~~ FOIL Ser. #: DEPARTMENT: .ASSESSOR Cl ACCOUN?ING ^ CODE ENFORCEMENT PLANNING t~ ZONING FIRE INSPECTOR U HIGHWAY ~-] RECEIVER OF TAXES f l RECREATION ~] ~' SUPERVISOR p TOWN CLERIC n WATER/SEWER U DOG CONTROL OFFICER D TOWN ENGINEER Cl TOWN ATTORNEY D T0: 92970579 P.8~9 i~ ss~s~ 2009-10-16 J~CM TOWN OF WAPPINGER Application for Public Access to Records FOIL REQUEST FOR DEPARTMENT 1„l~,E QNLY Date Received by Dept ~ / ~~ / ~3 Department Head approval; rt G- (init) Date Applicant Contacted: l~ / ~~/ /-3 Date FOIL 1£~Ilc~~nied: ~/ ~ / ~--3 .__ Closed by: ~~ Date: ~, l ,.L, l l-3 Notes: Amount Due: Pages for a total of $ Name: Address; 0 check here if you are requesting that the records t' 3 be mailed to this address. Agency or firm:;~v~~ i.~~c~a ~^p~ . Telephone #: (~y, )4~ 3 _ Uz.~x~ FAX #: (t~Jy) y~~- pZ ~ Email addross:..,~.'r-U.r~,r `_ inkarich. cct»a ._. DESCRIPTION OF RECORD: 3~TAK LIJ# I '5589 -~I Sr7_~ti~ FORMAT OF RECORD (if available) I request to be notifed when I can come to inspect the record(s) described above 0 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 C7 l request that the records be sent via a-mail to the address listed above fl I request that the records be faxed to the number listed above