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Formas Can Be Submitted via Email to lodell(i4townofwappingei-ngy or in person/via Mail to 20 Middlebush
Rel Wappingers Falls„ NY 12590
aeceived
FOR INTERNAL USE ONLY TOWN OF .PPGE
Application for Public A. s rds
Received by: Joseph P. Paalonl JLr
REQ
Lynas O"Gell �. �" � i
nger
_,,�
Lori McCaaaalogue.._,..� .cle
-
w :.� ,
Y.
Date Received: I
FOIL Ser. : .._ UjI
DEPARTMENT:
Address: '1\acv Y) requesting that the records
ASSESSOR
Agency or firm:
ACCOUNTING
Ful
CODE ENFORCEMENT
PLANNING
❑
ZONING
LI
FIRE INSPECTOR
1.
HIGHWAY
F1
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
❑
WATER/SEER
❑
DOG CONTROL OFFICER
1
TOWN ENGINEER
❑'
TOWN ATTORNEY
❑'
FEB 6" Z02
FOR DEPARTMENT USE ONLY
Date Received by Dept I I
Department Head approval:
(init)
Date Applicant Contacted: 2
Date FML fulfilled or denied: 2f
Closed by: &�e_
Date:
Nates: rjCV✓Gr j f`,
Amount Due: —Pages tier a total of $
Name: q\N q check here if you are
Address: '1\acv Y) requesting that the records
" be mailed to this address.
Agency or firm:
Telephone #: FAX
Email address: q CcA . uc
SPECIFIC DESCRIPTION OF RECORD:
f' _10 ..L,_r r 7" 5... _.% %VCi VC' k_ io j _._.
FORMAT OF RECORD (if available)
I ' I request to be notified when I can come to inspect the record(s) described above
I.. 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
I" I request that the records be faxed to the number listed above