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Forms Can Be Submitted via Email to lode] I@townofwappingerny. go or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph. P. Paoloni
Lynn O"Dell 1 1
Lori McConologue
Date Received: / ✓
FOIL Ser. #: ? L'I C
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
❑
ZONING
❑
FIRE INSPECTOR
❑
HIGHWAY
F]
RECEIVER OF TAXES
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
❑'
WATER/SEWER
❑
DOG CONTROL OFFICER
TOWN ENGINEER
❑
TOWN ATTORNEY
11
FEB 7 2023
lZ w~
FOR DEPARTMENT USE ONLY
Date Received by Dept / jn
Department Head approval:
"j.
Date Applicant Contacted: 2 / 7 /
Date FOIL fulfilled or denied: , /
Closed by:
Date:
-2/-7/23
St"',
Amount Due: Pages for dtotal of
Name: -�'— Le �, /-/ LJ check here if you are
Address:Z .-7 = .i jam— t'c requesting that the records
/ 0 S o be mailed to this address.
Agency or firm:
Telephone #: (j FAX #: ) -
Email address: c/- e,, t., _l L t
SPECIFIC DESCRIPTION OF RECORD:.
FORMAT OF RECORD (if available)
F I request to be notified when I can cone 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
1 request that the records be sent via e -n -tail to the address listed above
(, 1 request that the records be faxed to the number listed above