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Forins Can Be Submitted 'via Retail to lode LI( or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni n
Lynn O'Dell V
Date Received:
FOIL Ser. fi;
OVV
DEPARTMENT:
ACCOUNTING
CODE ENFORCEMENT
ZONING
FIRE INSPECTOR.
HIGHWAY
RECEIVER OF TAXES
RECREATION E
SUPERVISOR L
TOWN CLERK F
WATER/SEWER
DOG CONTROL OFFICER L
TOWN ENGD4EEK
TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
'A"
'7'OWN
TMENT USE ONLY
Date Received by Dept ?
Department Head approval:
Date Applicant Contacted: 41
Date FO, (clfill4e� denied -
Closed by: , I
Date:
Notes:
qlq / 00d -E
Amount Due: _ Pages for a total of $,
Name: Je*' Y),,-Q.r CJhet<. , E check here if you are
Address: q_requesting that the records
v�N-)nsy;be mailed to this address.
Agency or firm: 64 Pao kf' ie_
Telephone: I-110,�) FAQ #:
Email address: n -'C P�
,sc - T^ tc�'A CCL!
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SPECIFIC DESCRIPTION OF RECORD:
Le �Les f 6 � C LIP t, 1� C 'Ile L/k r CCL 63 y—,k h c,, L,
J
11'12.. (J'.1AV) rf�ViOr'L_ 01) t'Z -h
FORMAT OF RECORD (if available) O'S7 _11113 - 141 0
I request to be notified when I can come to inspect the record(s) described above
1 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
F11 I request that the records be faxed to the number listed above