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Forms Can Be Submitted via Email to lmccoriologLie(ci,townofwappingemy. ov or
grobinson(cl,townofwal)pingerny.gov or in person/via nail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P'. Paoloni
Lori McConologUe
Grace Robinson N...i
Date Received:
FOIL Ser. ##:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
D
CODE ENFORCEMENT
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HIGHWAY
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RECEIVER OF TAXES
FORMAT OF RECORD (if available)
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
RECREATION
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SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
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TOWN ATTORNEY
7
Name:
Address,
:
TOWN OF WAPPINGE .
Application for Public Access to Records
TOWN OF WAPPINGOk
FOR DEPARTMENT USE ONLY
Date Received by Dept TA -` '0
Department Head approval:
1mt
Date Applicant Contacted: /../
Date F IL fuihlle dor denied: ""/ /A
Closed by:
Date:
w
Notes.
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Amount Due: ---"Pages for a total of $'
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Agency or firm: ' ----
Telephone ##: (` FAX #: ( )
Email address: '
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[]check here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION Vr2F RECORD° ,
y 1` aG
FORMAT OF RECORD (if available)
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
ON