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Forms Can Be Submitted via Email to lodell@townofWappingemy,gov or
ImcconologueLdtownofwqppingemy.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY
12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni [1
Lynn O'Dell -.1
Lori McConologue
Date Received:
FOIL Ser. 4:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
❑
CODE ENFORCEMENT
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x
71 3
PLANNING
El
ZONING
Notes:
FIRE INSPECTOR
HIGHWAY
Amount Due: Pages for a total of $
RECEIVER OF TAXES
❑
RECREATION
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SUPERVISOR
F-1
TOWN CLERK
F]
WATER/SEWER
F-1
DOG CONTROL OFFICER 0
TOWN ENGINEER
M
TOWN ATTORNEY
E]
2 7
"U�ICI�09 Depaqrjent
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
j_
x
71 3
Date FOIL fulfilled or denied: /
Closed by: f.. --
Date:
Notes:
Amount Due: Pages for a total of $
Name: J -5A- -7 C— L V(k-SV[_--36V& aA`jb)-1)101 F-1 check here if you are
Address: 16, no�,�.j,4-jqr_-t :D 21 vrequesting that the records
_ p t � j 1,j be mailed to this address.
Agency or firm:
Telephone #: FAX #
Email address:
SPECIFIC DESCRIPTION OF RECORD: Ca
W'f.E�Jrs F ( L
. . .... ....
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
F� I request that the records be faxed to the number listed above