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Forms Can Be Submitted via Email to lodell g(towpofwappingerriv.gov or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloin
Lynn O'Dell
Lori McCo�iologue
Date Received:
FOIL Scr. c)
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
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PLANNING
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ZONING
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FIRE INSPECTOR
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HIGHWAY
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RECEIVER OF TAXES
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RECREATION
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SUPERVISOR
TOWN CLERK
WATER/SEWER
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DOG CONTROL OFFICER
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TOWN ENGINEER
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TOWN ATTORNEY
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Name:
Address: l fr:
TOWN OF WAPPINGER
Aglidition for Public Access to Records
e FOIL REOUEST
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted: _LL / _L / _2_3
'71
Date FOIL fulfilled or denied:
Closed by:
Date:
Notes:
Amount Due: — Pages for a total of $ ,—
Agency orfirim g(,, �4,1 -,
Telephone #: q v �AX #:
Email address:
I check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD: Qj
... ............. ........ . . ... ..........
..........
FORMAT OF RECORD (if available)
7v/ 1 request to be notified when I can Come to iDSPCCt 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
F_ I request that the records be faxed to the number listed above