Acosta, Magdalena GaragePennit Applicatioll
Return to: Town Clerk
Town of Wappiner
20 Nliddle�bush Rd,
Wappingers Falls, NY 12590
Name: Lo-L2
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(Sheet AAddress) _
Wappingers Falls NY 12590
(City) (S'r) (Zip)
Address of Sale:. cb(,�)� A,
(If different from above) (Street Address)
Wappingers Falls, NY 12590
(city) (S ) (Zip)
,w
bate of Sale; From: _ (a /pth) until a l th)
(Day One) (Time Begin) r (Tune End)
DW Two) Froth; (Tmgri} 'a1 pm) until (Tune (atpru
From: _ (arn/prn)until (am/pm)
(Day Three) (Time Btgin) (Time End)
Sign: , ;: Date: �° (
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FOp. INTERNAL USE ONLY
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Received by: Joseph P. Paoloni.
AR Jessica Fulton.
Date Received:
Serial ;