Farrell, Carol Garage ale Permit Application
Return to: "town Clerk.
Town of Wappiner
..........
20 Middlebush Rd..
Wappingers Falls, NY 12590
Name;
( psi) (First) (MI)
Address:
(street Add ess) SEP 16 2019
Wappingers Falls, NY 12590
(City) (ST) (Zip) TOWN OF WAPPINGER
Phone. `y -z,6 `1"(Wim ro r n s/.
Address of Sale:
(If different from above) (street Address)
Wappingers Falls NY 12590
(City) (ST) (Zip)
r
Date of Sale: " 1 °` From: (ani/pin.) until ? (arn/pm)
(1)4 orre) (Time Begin) (Time End)
From: (am/pin)until (am/pin)
(I)ay Two) (Time Begin) (T'irtie End)
From: (am/pm) until � (am/pm)
(Day Three) (Time Begin) (Time End)
Sign: Date: ✓
l
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Jessica Fulton
Date Received:
Serial #: