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Forms Can Be Submitted via Email to Imeconolo Lieei;townofwappin errs ov or
.. rroobinsonotownofwappingerny.gov or in person/via mail to 20 MiddlebuArRd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni ❑
Lori McConologue 11
Grace Robinson F
Date Received;
FML Ser. ##: �! - —
ASSESSOR
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ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
0
RECEIVER OF TAXES
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RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
❑
WATER/SEWER
❑
DOG CONTROL OFFICER ❑
TOWN ENGINEER
TOWN ATTORNEY
❑
Application for Public Access to Records
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department. Head approval:
(irr�t�
Date Applicant Contacted: �� / t"`1 / 23
Date FOIL fulfilled or denied:
Closed by:
Date:
Notes:
P/ % / 'D
Amount. Due; ages for a total of $
Nance: 05 kir'-+— C I �) []check here if you are
Address: 15 Y tA-vt577 requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: (�45 ) CiS - J,—W? FAX #:
Email address: raa+'r m► 6n-�
SPECIFIC DESCRIPTION OF RECORD:
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 coast 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
12/07/2023
Town of Wappinger
20 Middiebush Rd.
Wappingers Falls, NY 12590
(845) 297-6256
FEES PAI®
Reference:
Joshua Conklin 6258-03-499100-0000
Conklin, Joshua
19 Cady Ln
®ate Fee Check No. Receipt No. PayType Amount
12/07/2023 CfJP15 2023-02370 CASH $2.22
This is a receipt for payment of fees. This is not a building permit.
®ate printed: 12/07/2023
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Printing I Copying I Design I Mailing
1299 Route 9 Ste 105
Wappingers Falls NY 12590
845-298-8898
Accounts Payable
Town Of Wappinger
20 Middlebush Road
Wappingers Falls NY 12590
SHIP TO:
Town Of Wappinger
20 Middlebush Road
Wappingers Falls NY 12590
Fax:297-4558
Received by
Date
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Terms Net 3.0 Days
Pay from this invoice
Dutchess Proprint, 1299 Route 9 Ste 105 - Wappingers Falls NY 12590 , 845-298-8898 (print# 1)
TERMS AND CONDITIONS ARE LSTED ON REVERSE SIDE.
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Received by
Date
-2 32
0 10
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BALiNcei, o
Terms Net 3.0 Days
Pay from this invoice
Dutchess Proprint, 1299 Route 9 Ste 105 - Wappingers Falls NY 12590 , 845-298-8898 (print# 1)
TERMS AND CONDITIONS ARE LSTED ON REVERSE SIDE.