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Forms Can Be Submitted via Email to ImcconOlOgLIeCotownofwappingerny.gov or
,gi-ob,insoiioa,townofwappingeniy.go or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni -1
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Lori McConologue u ��
Grace Robinson F.]
Date Received:—/—/
FOIL Ser, #: �)-Ca5 — `�-�q
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RECEIVER OF TAXES
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RECREATION
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SUPERVISOR
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TOWN CLERK
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WATER/SEWER
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DOG CONTROL OFFICER F]
TOWN ENGINEER
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TOWN ATTORNEY
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Name:
Address:,
Agency or firm:_
Telephone #.
Email address:
SPECIFIC DESCRIPTION OF
TOWN OF WAPPINGER
Application for Public Access to Records
L REQUEST
n
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
.*i n i t)7
Date Applicant Contacted: /,)G-/ d-6--)-3
Date FO fulfilled oy, denied:
Closed by:
Date:
Notes: C WAIC)
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Amount Due: -0 Pages for a total of $
check here if you are
"questing that the records
7L�l n l be mailed to this address.
FAX #: (
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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
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
Victor Rivera
Town of Wappinger
20 Middlebush Rd.
Wappingers Falls, NY 12590
(845) 297-6256
FEES PAID
Reference:
6257-01-015672-0000
Rivera, Victor
4 Stanley Ln
70/30/2023
Date Fee Check No. Receipt No. PayType Amount
10/30/2023 COPIES 2023-02111 1 CASH I SO.SO
This is a receipt for payment of fees. This is not a building permit.
Date Printed: 10/30/2023