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Forms Can Be Submittcd via Entail to lodell@townofwappingcrny.aov or
lmccoIxolo)Zue(La7townofwap_p ngemy.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY
1.2590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 7
Lynn O'Dell
1
Lori McConologue
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT'
PLANNING
[]
ZONING
[]
FIRE INSPECTOR
1request to be notified when I can come to inspect the record(s) described above
HIGHWAY
I request copies of the records described above and agree to pay the cost of such records in.
RECEIVER OF TAXES
❑!
RECREATION
❑
SUPERVISOR.
I request that the records be faxed to the number listed above
TOWN CLERK
0
WATER/SEWER
E]
DOG CONTROL OFFICERE]
TOWN ENGINEER
TOWN ATTORNEY
MAY 2 2 �^��. 3
*mr ,' O, �.
a,
FOR DEPARTMENT USE ONLY
Date Received by Dept /tn Department Head approval:
it)
Date Applicant Contacted: 6 / /
Date FOIL fulfilled or denied:
Closed by:
Date:.
Notes: &, LS c ecyj
-
6 `w r L 7 e C1u" _ Cry r
Amount Duc: — Pages fora total of —
Name:
Address: y, e
Agency or firm: 2 r.' X, " 71
Telephone #: (Y- i } 5 / l - / FA,X�#: ( }
Email address:
check here if you are
requesting that the records
be mailed to this address.
SPECIFIC D SCRIPTIO OF RECORD:
C _.C",1,44- C>_.. ,
FORMAT OF RECORD (if available)
1request 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.
❑I
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