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Forms Can Be Submitted via Email to lodell),townofwa pingerny, v or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 1.2590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paolonl J
Lynn O'Dell
Lori McCoilolo,gue F
Date Received: / IIr
FOIL Ser. #: 2 6`'
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
C
PLANNING
ZONING
❑
FIRE INSPECTOR
❑
HIGHWAY
RECEIVER OF' TAXES
❑
RECREATION
LI
SUPERVISOR
::I
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
❑
TOWN ENGINEER
El
TOWN ATTORNEY
❑
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL RE t2ce
i e
PAR 03
2023
1G��I�t li'jtia /ll
`AOR DEPARTMENT USE ONLY
Date Received by Dept / � / -
Department Head approval:" ";
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Date Applicant Contacted:
e
lr denied: ,j / �
Date FOIill
: ilFd,,�
Closed by:,
Date: / .R_ / .
Notes:41,
1,t
Amount Due: Pages for a total of
Name: c _ G _ -1 check here if you are
Address: -(--2_ requesting that the records
be mailed to this address..
A g c n c y or firm:
Telephone #: w FAX #: ( -
Email address:
SPECIFIC DE IPTION OF RECORD
FORMAT OF RECORD (if available)
I 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
L i request that the records be sent via e-mail to the address listed above
I request that the records be faxed to the number listed above