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Forms Can Be SUbmitted via Email to lodellG'Nownofwappittgerny.gov or in person/via mail to �D N` lebush
Rd Wappingers Falls, NY 125941 neV�
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 11
Lynn O'Dell 11
Lori McConologue F,>'
Date Received:
FOIL Ser.
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
CGDE ENFORCEMENT
PLANNING
❑
ZONING
❑
FIRE INSPECTOR
L1
HIGHWAY
LL
RECEIVER OF TAXES
LL
RECREATION
L1
SUPERVISOR
H
TOWN CLERK:
L
WATER/SEWER
DOG CONTROL, OFFICER
�
TOWN ENGINEER
L1
TOWN ATTORNEY
11
TOWN 0 . W0�oftA
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Application for Pub ic`W- ss to Records
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Btja C ng Depjji tr(j,,^aat: "
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted: 3 /0/97
Date FOIL fulfilled or denied:303/03
Closed by:
Date:
/
Notes: tn7ove oc ztg-& r"�,i4 a ,_0a�
Amount Due: —--Pages for a total of $
Name; 612 C L .-.I check here if you are
Address: requesting that the records
AI.r✓ i _/%-"; be mailed to this address.
Agency or firm:
Telephone #: (�' 9 ) J FAX ##:
Email address:
SPECIFIC DESCRIP'T'ION OF RECORD:
1Co-c a fr C ars'
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FORMAT OF RECORD (if available)
l 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
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