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Forms Can Be Submitted via Email to lodell(cDte nofwat)piriy.�4ov or ill person/via mail to 20 Mi l LIslI.
Rd Wappingers Falls, NY 12590 ,
FOR INTERNAL USE ONLY
Received by: Joseph. P. Paoloni J
Lynn O'Dell I
Lori McConologue Cw++
Date Received
FOIL Ser, #: o, .. C) -,
DEPARTMENT:
ASSESSOR
CV
ACCOUNTING
C
CODE ENFORCEMENT'
C
PLANNING
C
ZONING
C1
FIRE INSPECTOR
Ll
HIGHWAY
F1
RECEIVER OF TAXES
❑
RECREATION
SUPERVISOR
L
TOWN CLERK
L]'
WATER/SEWER
U
DOG CONTROL OFFICER
F1
TOWN ENGINEER
L�
TOWN ATTORNEY
C .V
TOWN OF,�A1?F
Application for Pub liic A&GAYP6 Records
W16ng Dep rtv)"E 1.1
"Tema, of Wap6r�o a
Date Received by Dept 3 /V /
Department Mead approval: CAJ
(init)
Date Applicant Contacted; 1 I
Date FOIL fulfilled or denied: - / /
Closed by:
Date:
/'�'7 / D'33
Notes: lxv Cr Gm c
Amount Due; — Pages for a total of
Name: -1 check here if you are
Address: ,� �' - requesting that the records
a be mailed to this address,
Agency or firm:
Telephone #; - AX )
Email address: ,L- 17- �V. /
SPECIFIC DESCRIPTION OF RECORD:
' '
r
FORMAT OF RECORD (if available)
F I request to be notified when I can come to inspect the record(s) described above
L 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
I ' I request that the records be faxed to the number listed above