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Forms Can Be Submitted via Email to lodell ,townofwa in ern . ov or in person/via snail to 201'vliddlebush
Rd. Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lynn O'Dell
Lori McConologue u
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
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CODE ENFORCEMENT
PLANNING
I-1
ZONING
-1
FIRE INSPECTOR.
I
HIGHWAY
F1
RECEIVER OF TAXES
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RECREATION
1
SUPERVISOR
I V
TOWN CLERK
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WATERISEER
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DOG CONTROL, OFFICER
0
TOWN ENGINEER
EV
TOWN ATTORNEY
EI
TOWN OF WAPPINGE
Application for Public Access to Records
..FOIL REO UEST
ARTMENT
Date Received by Dept/ Wit) Department Head approval:
Date Applicant Contacted J /
Date FOI fulfilled �o� denied;
Closed by -
Date: /
Notes: .
Amount Due: Pages for a total of
Name: e I/ h. :check here if you are
Address: 7� t requesting that the records
%Dbe mailed to this address.
Agency or firm:_
Telephone #: FAX : ( -
Email address: -
SPECIFIC DESCRIPTION OF RECORD:,
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Own ar
AT OF RECORD (if available} ji µ
. , T wn erk
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
I request that the records be faxed to the number listed above