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Forms Can Be Submitted via Email to lodell townofwappingemy.g_a r or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P, Paoloni El
Lynn O'Dell NQ
Lori McConologue ❑
Date Received: / /
FOIL Ser. #: 2 fir'
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
❑
FIRE INSPECTOR
❑
HIGHWAY
❑
RECEIVER OF TAXES
Cl
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
❑
DOCS CONTROL OFFICER
11
TOWN ENGINEER
11
TOWN ATTORNEY
Ll
TOWN OF W A.P'P IN ER
Application for Public Access to Records
OlL - .
-
Wn Of Wapp,iTown of Wap,
.,
1 �,
�Vvrt l,.ierk
FOR DEPARTMENT USE ONLY
Date Received by Dept+
Department Head approval: 4� ,
Date Applicant Contacted: 3 / /
Date FOIL fulfilled or denied: 3 / /
Closed by: (Uhcza_
Date: 3/1/0
Notes: J _1"
Amount Due: ..Pages for a total of $ -
Name: ❑ check here if you are
Address: AG Le requesting that the records
E be mailed to this address,.
Agency or firm:
Telephone -_-ZI&CT FAX
Email address:
SPECIFIC DESCRIPTION OF RECORD: }
Ci r�^ it `� —tC D } v"M�w1 q
FORMAT OF RECORD (if available)
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
E I request that the records be sent via e-mail to the address listed above
E I request that the records be faxed to the number listed above
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