2024-35Click I la ic To Sciu-ch Out- PuNic Rccor(]s Hcf0i-c Submitfiffl,() Request
F01 -111S Call 13C SUIA11HIC(t Via LmaiI tO 1111CC )t 0N01JUCVI arra go 01
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or In person I via mail to -10 MiddlebUSh Rd \VaP[)itlgCrS F,111S, NY 12590
FOR IN I`RNAL USE ONLY
Rccelvcd by: Joseph 1'. Paololli
L'ori McCollo4q glic tl�
Go -ace Robillson
Date Received:
FOIL. Ser at: A , `0
DEPARTMENT:
ASSESSOR
A C' CO U NT INCA
CODE I"NFORCTMENT
HIGHWAY
RECEIVFR OFTAXFS
El
RECREXTION
El
SUPERVISOR
El
"LOWN (TERK
WATL,R)ISEWER
DOG CONTRC)L, 0 F F� C I-R
El:
TOWN FNGINFER
11
TOV\l`N Al"TORNEY
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Agency or firm:
Emad address:
Sk F�CIHC DF'SCRiP'rl0N OF RECOR.D:
1'0RN4,,VH)FRE('(.)1~ D Ofavailable)
DC)'WN F W1PINGER
APPli,I
tion for Nitfl ic Access to Records
aecelVet
FOIL, REOU#R_E�C L -PT,
FOR DEPARTM ENT USE, ONLY
. ..... ......
Date Received by Dept
Department head approval:
Date Applicant Contacted: 1�q �Q (-/
Date FOIL fulfilled or denied-.
Closed by:
Date:
Notes: SC_c4,md.
Amount DDC: --_ PagCS I'01 -a total 01'S
[:]check here ifyou are
l'C(IUCStlllg that the rccords
be mailed to this address.
l*CCjUk2Sl do he notified %vhen I can Col -11C to Inspect the record(s) describ
I requost Copies of tll(.' 1-ccords (icscribed above and agree to pay the cos
C
, CORL.mcc with the fc�: sclicclule on the back ofthis application
El'111-CCIUeSt that the records he sent vla c-rtml to the address, listed abo�c
1:1 1 reqLICSt that the records be ffi\ed to 111C IlUmbor listed above
Cor,
BuIldfng Depjrtment
Town Of WaPpInger