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Forms Can Be Submitted via Email to Ian-iccoij€ igg�jc towii.oLLa � piii erriy.�gy or in person/via mail to 20
Ivliddlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConologue
Date Received:/ _ /
_
FOIL Ser. #; `'
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
PLANNING
ZONING
FIRE INSPECTOR
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
TOWN OF W, PPINGE
application for Public Access to Records
ec FOIL RE1 EST
K 917
& % " NY
FOR DEPARTMENT USE ONLY
:Gate Received by Dept 012, Z
Department Head approval:
0 t)
Date Applicant Contacted:
Date FOIL fulfilled or denied:. Of
Closed by: 00
Date:
Notes:
Amount Due: Pages for a total of '$
Name: check here if you are
Address: 113 requesting that the records
at be mailed to this address.
Agency or firm:,r I l ; C
Telephone #: (_ - FAX #:
Email address:.mmt--1- CA!A_%r1?
SPECIFIC DESCRIPTION OF RECORD:.
FORMAT OF RECORD (if available)
1 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
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