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Forms Can Be Submitted via Email to Imcconologue(cDtownofwappiDgPI-nY,gOV or
grobinsonp,i[owiiofwappingern y.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 11
Lori McConologue n
Grace Robinson 0
Date Received,
FOIL Ser. #: _�- 0 a- a,
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
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RECEIVER OF TAXES
El
RECREATION
11
SUPERVISOR
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TOWN CLERK
1:1
WATER/SEWER
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DOG CONTROL OFFICER n
TOWN ENGINEER
El
TOWN ATTORNEY
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TOWN OF WAPPINGER
Applica ion for Public Access to Records
FOIL REOURI �_'
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval.
Date Applicant Contacted
Date FOIL fulfilled or denied:
Closed by:
Date:
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Notes: 1-C,
Amount Due: Pages for a total of $
Name:h1L'Q_L hnv) []check here if you are
Address: '7- �aqd So,'k Lc��_ requesting that the records
beoa GT (Mol b.e mailed to this address.
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Agency or firm-:—)he� N/,'11,,on ry-1 3 0 L 4 T'a�_ _(/b 1, P "Ar TA
Telephone #:('t�:N ))�6 -6�bBto66qFAXff:'(�o?j
Email address: PhC't)q-i(T'C i0--rc) �rjcoM
SPECIFIC DESCRIPTION OF RECORD:
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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