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45C1ic1f Here To Search Our Public Records Database Before Submitting Request Forms Can Be Submitted via Email to lodell townofwa in ern . ov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590 FOR INTERNAL USE ONLY Received by: foseph P. Paoloni Lynn O'Dell ❑ Lori McConologue ❑ Date Received: 2- I H_l7j FOIL Ser. #: s& z . DEPARTMENT: ASSESSOR ❑ ACCOUNTING ❑ CODE ENFORCEMENT PLANNING ❑ ZONING ❑ FIRE INSPECTOR ❑ HIGHWAY ❑ RECEIVER OF TAXES ❑ RECREATION ❑ SUPERVISOR ❑ TOWN CLERK ❑ WATER/SEWER ❑ DOG CONTROL OFFICER ❑ TOWN ENGINEER ❑ TOWN ATTORNEY ❑ Name: Address: Agency or firm: Telephone #: (9'�5 ) SSgj - %3 �1 Email address: TOWN OF WAPPMGER Application for Public Access to Records FOIL REQUEST FOR DEPARTMENT USE ONLY Date Received by Dept / / z Department Head approval: q - - nit) Date Applicant Contacted: /(-7 / Date FOIL fulfilled or denied: / �I 7 / Closed by:Y4 5 = Date: 1 i? / Notes:CAS t,C Amount Due: Pages for a total of $ FAX #: ( } - SPECIF C DESCRIPTION OF RECORD: V e iZ. ti►T 1eCCat�n q!, US ❑ check here if you are requesting that the records be mailed to this address. FORMAT OF RECORD (if available) ❑ 1 request to be notified when I can come to inspect the record(s) described above ❑ 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 ❑ I request that the records be sent via e-mail to the address listed above 0 1 request that the records be faxed to the number listed above