Cornell, Karen F �
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Garage .l It Application
Return to: Town Clerk.
Town ofWappin er
20 Middlebush Rd..
Wappingers Falb, NY' 12590
Naive: stj ...m .. (First) (MI)
Address: -7,-2 &ec, 1 p g �ry q
(Street Address) Q F N 6 2019
9
Wappingers Falls NY 12590
(City) (ST) (Zip) TOWN OF WAPPINGER
MNi ri
Phone: ( ili, !-
Address of Sala:
(If different from above) (Street Address) .
Wap angers Falls,NY 12590
(City) (ST) (Zip)
Date of Sale:
Jf From: (am/ptn) until (am/pm)
(D, Orbe) (Tune Begin) (Time:End)
From: ��(am/pm) until _ `" (ain/p )
D° Two) {Tune Begin) (Tine End)
/ From: �" (am/pm) until (anfpn)
(Day Three) (Time Begin) (Tinge End)
Sign: Date: �
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni.
Jessica Fulton
Date Received:
Serial #: