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20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni Ll
Lynn O'Dell 0
Lori McConologue R
Date Received:
FOIL Ser. 9:
DEPARTMT4NT:
ASSESSOR
ACCOUNTING
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CODE ENFORCEMENT
FORMAT bF RECORD (if available) e �dl
PLANNING
0 1 request copies of the records described above and agree to pay the cost of such records
ZONING
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FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
0
RECREATION
❑
SUPERVISOR
TOWN CLERK
El
WATER/SEWER
11
DOG CONTROL OFFICER
0
TOWN ENGINEER
TOWN ATTORNEY
Name: t.
Address:
Agency or firm:
Telephone #:
Email address:
TOWN OF WAPPINGER
Applica6& for Public Ace ss to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept /.�3_
Department Head approval:
(init)
Date Applicant Contacted: 1 /2 G� / -a
Date FOIL fulfilled or denied: dl
Closed by:
Date:
Notes: bab-a,
Amount Due: Pages fora total of$
16", 0 check here if you are
ULL requesting that the records
�L..n -f-4 P. \,�mu� I d1 be mailed to this address,
FAX
,SPECIFIC ESCRIPTION OF RECORD:
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FORMAT bF RECORD (if available) e �dl
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I request to be notified when I can come to inspect cors) 1] s t e or le'scribed above
0 1 request copies of the records described above and agree to pay the cost of such records
accordance with the fee schedule on the back of this application
11 1 request that the records be sent via e-mail to the address listed above C C
01 1 request that the records be faxed to the number listed above
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