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Forms Can Be Submitted via Email to lade.1C)i
Rd Wappingers Falls, NY 12590 :1��-n �,oy or in person/via mail to 20 Middlebush
FOR INTERNAL USE ONLY
Received by, Joseph P. Paoloni 0
Lynn O'Dell
Lori McConologue
Date Received:
FOIL Ser. #.
DEPARTMENT:
ASSESSOR
Cp
ACCOUNTING
CODE ENFORCEMENT
XC
PLANNING
11
ZONING
11
FIRE- INSPECTOR
11
HIGHWAY
0
RECEIVER OF TAXES
El
RECREATION
SUPERVISOR
TOWN CLERK:,
WATER/SEWER
DOG CONTROL OFFICER
0
TOWN ENGINEER
0
TOWN ATTORNEY
11'
Name:
Address:
Agency or firm: -
Telephone #.- ( Kyr-) j�q
Emailaddress.
SPED IC DES TION OF RECORD.
R
TOWN OF WAPPINTER
Application for Public Access to Records
Received FOIL REOUEST
long M,
W I I n of Wapping
IN
W,_ Town Clerk
111ding F)t,
�Partm It.
"4 OF WAPPruvrntr
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval: Ll
Init)
Date Applicant Contacted -
Date F0 Mdrydenied:
Closed by:4;�--
Date: Lo
Notes:
Amount Due. P_age______
s for a total of,$
0 check here if you are
requesting that the records
be mailed to this address.
4 n
FAX #.('
FORMAT OF RECORD (if available)
0 1 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
I request that the records, be faxed to the number listed above "'A"tA
I request that the records be sent via e-mail to the address listed above
0