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Forms Can Be Submitted via Email to lodellL&,townofwappincern y.jgo or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni -1
Lynn O'Dell 7
Lori mcconologue N�
Date Received:
FOIL Ser. #: c) C1
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING LI
ZONING
F1
FIRE INSPECTOR
Ll
HIGHWAY
F1
Er
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
El
TOWN ENGINEER
TOWN ATTORNEY
TOWN Oy-pAA 91 er
Application for Vublic t cords
REOUEST
Mw
T'
0
Date Received by Dept
Department Head approval
Date Applicant Contacted:
Date F0110-1-Ir-liled or denied
Closed by:
_3
(init)
3 1-31 / '1"�3
Date:
Notes:
Amount Due: _ Pages for a total of
Name: -1 check here if you are
Address: requesting that the records
11 tl)� !11 !ef be mailed to this address.
Agency or firm: 1 ?-6,46
Telephone #: (� Ci 5 FAX #:
Ernail address: 0 'o 5, Nywri 0 /. (e"n
SPECIFIC DESCRIPTION OF RECORD:
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. ..... ....... ................. . . .............................. . ............. . .... . ................. . ...... .. . ...... ...
FORMAT OF RECORD (if available)
1,13721,36F
F 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
G. 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