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Forms Can Be Submitted via Email to lcncconologue(c%!towiiofN app aigel�ny. ov or
grobinson (Zbtowno-Ryappingerny.gov or in person/via nail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by Joseph P. Paoloni F1
Lori McConologue
Grace Robinson
Date Received: / f
FOIL Ser. } t
(DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
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RECREATION
SUPERVISOR
TOWN CLERK
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WATER/SEWER
DOG CONTROL OFFICER F
TOWN ENGINEER
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TOWN ATTORNEY
F
Application for :Public Access to Records
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FOILREO
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FOR DEPARTMENT USE ONLY
Date Received by Dept / J
Department Head approval:
(nnt)
Date Applicant Contacted:
Date FOIL fulfilled or denied: "7/
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Closed by:
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Date:
Notes: 71-NE0 CPA.
Amount Due: Pages for a total of
Name: Arby lie a ncheek here if you are
Address: 105 Park AvQ _ requesting that the records
be mailed to this address.
Agency or firm;
Telephone #: (203 ) 898 -5227 FAX : ( ) -
Email address: arbygegaC@gmail.com
SPECIFIC DESCRIPTION OF RECORD:
28 Edge Hill rd violations/records
FORMAT OF RECORD (if available)
IH
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
14 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
1 request that the records be faxed to the number listed above