Ducus, William Garage 1
G age Sae Permit Application
Return to: Town Clerk
y, Town of Wappinger
20 Middlebush Rd.
Wappingers Falls,NY 12590
Name: �� } ,�
(East) (F t)
Address: n' ��
(Street Address)
Wappingers Falls,NY 12590
(City) (ST) (Zip)
Phone: 2tH 1`33�J .
Address of Sale: �J
(If different from above) (Street Address)
Wappingers Falls,NY 12590
(City) (ST) (Zip)
Date of Sale: From: (am/pm)until (am/pm)
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From: (am/pm)until '73 (am/pm)
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Sign: Aa-lwtuv Date:
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FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni ❑
Grace Robinson ❑
Date Received:
Serial#: