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Forms Can Be Submitted via Email to lodell�Dtownofwaopin erny. rov or in persori/via mail to 20 Middlebush
Rd Wappingers ]Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lynn O'Dell l
Lori McConologue
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
❑'
CODE ENFORCEMENT
4
PLANNING
❑
ZONING
FIRE INSPECTOR
HIGHWAY
1-1
RECEIVER OF TAXES
RECREATION
❑'
SUPER'V'ISOR
❑
TOWN CLERK
WATER/SEWER
❑
DOG CONTROL OFFICER
❑
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
FEB 10 2023
Town of Wappinger
t
FOR DEPARTMENT USE ONLY
Date Received by Dept I /
Department Head approval:
`(iiiit)
Date Applicant Contacted: r l A I
Date FOIL fulfilled or denied:
Closed by:i✓ ,.✓'"'
Date:
Notes: n,uj e C cr)j es of" e
Amount Due: ,.,.; Pages for a total of $ .. Mi
Name: ., 1 e_ J check here if you are
Address: o e_ Z requesting that the records
t F -s -a-1 be mailed to this address.
Agency or firm: '
Telephone ##: vsj2 F& 7 PAX #: ( ) -
Email address: r"� .-- o Y z �+.,r + mar
SPECIFIC DESCRIP ION OF RECORD:
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C
CC
FORMAT OF RECORD (if available)
I� equest to be notified when I can conic to inspect the record(s) described above
I request copies of the records described above and agree to pay the east 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
F I request that the records be faxed to the number listed above
Robert Palumbo
Town of Wappinger
20 Middlebush Rd.
Wappingers Falls, NY 12590
(845) 297-6256
FEES PAID
Reference:
6356-01-188875-0000
Palumbo, Robert
305 Route 82
02/10/2023
Date Fee Check No. Receipt No. PayType Amount
02/10/2023 1 COPIES 1 12023-00190 1 CASH I $0.75
This is a receipt for payment of fees. This is not a building permit.
Date Printed: 02/10/2023