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Forms Can Be Submitted via Email to IMCCOIIOJOgLIC&Lownofvrappin erny. or
grobinson c7,tovwnof appingemy. ov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FORINTERNALUSE ONLY
Received by: Joseph P. Paoloni
Lori McC�onologue
Grace Robinson 0
Date Received:
FOIL Ser, #:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
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WATER/SEWER
DOG CONTROL OFFICER
TOWN ATTORNEY
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;e�uildjng Departrient
Town Of Wappinger
FOR DEPARTMENT USE ONLY
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Date Received by Dept 911
Department IIead approval:
kc t)
Date Applicant Contacted: 5 JW
Date FOIL r denied: ?
Closed by:
Date:A-)I, dd)
Notes
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Amount Due: Pages orajtot6al of,
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Name- F� check here if you are
Address: i 3 (D requesting that the records
`Ery Its "-q]�TSD be mailed to this address.
Agency or firm:
Telephone #: -q t q,) _�L7 5 5 5q -7 FAX #:
Email address: El d,5 -C' 4-� -rra i I C L, M
SPECIFIC DESCRIPTION OF
y
FORMAT OF RECORD (if available) J 3�)
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
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
T request that the records be faxed to the number, listed above