114Received
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Forms Can Be Submitted via Email to lodell��townot�v�pingcrny gov or in person/via aaaa l R 100ebush
Rd Wappingers Falls, NY 125911
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni �j
Lynn O'Dell 1
Lori McConologue [
Date Received:
FOIL Ser. #: �, .._ -1
DEPARTMENT:
ASSESSOR L
ACCOUNTING
❑
CODE ENFORCEMENT
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PLANNING
Li
ZONING
❑
FIRE INSPECTOR
L
HIGHWAY
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RECEIVER OF TAXES
F
RECREATION
L1
SUPERVISOR
El
TOWN CLERK
El
WATER/SEWER
Ci
DOG CONTROL OFFICER
L
TOWN ENGINEER
F-1
TOWN ATTORNEY
LI
of \Nappinger
TOWN 01%�OwWiMR
Application for Public Access to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
(init)
Date Applicant Contacted:
d /'
Date FOI full fled"r denied:
Closed by:
Date:
d 4_/d
&W,Notes:12 IS d a
Amount Due: a ^,' Pages for a total of S
Name: 0 V -op? ler -1 check here if you are
Address; requesting that the records
LA).(L 11 a [ � be mailed to this address.
Agency or firm:.
Telephone #., (LJ ` �` -,-.. FAX #: ( )
Email address: SCC: Kleo np. eco �c o . ( -,
SPECI7620)s
DESCRIP ION OF RECORD:
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FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the rccord(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
L' 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
Aaron Klein
Town of Wappinger
24 Middlebush Rd.
Wappingers Falls, NY 12590
($45) 297-6256
FEES PAID
Reference:
6257.01-015933-0000
Klein, Aaron
5 Roberts Rd
04/04/2023
Date Fee Check No. Receipt No. Payiype Amount
04/04/2023I CONES 1 12023-00536 CASH $0.50
This is a receipt for payment of fees. This is not a building permit.
Date Printed: 04/04/2023