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Forms Can Be Submitted via Email to 1mccono!2gj!L(ajLtqwq9j7�yap 'ngejqy. ov or
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FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 11
Lori McConologue
Grace Robinson 11
Date Received,
FOIL Ser,
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ASSESSOR
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ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
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TOWN ENGINEER
TOWN ATTORNEY
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TOWN OF WAPPINGER
Application for Public Access to Records
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Date Received by Dept _3
Department Head approval:
Date Applicant Contacted: 0 / () ( / ") V'I
2
Date FOIVCIfilledr denied: _-
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Closed by:
Date:
Notes:Prn d ri�q wi k d f
Amount Due: _ Pages for a total of $
Name: E]check here if you are
Address: it
requesting that the records
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Agency or firm:
Telephone #:( 94S )i?q(, _5qqFAX #:
Email address: l4 dank e (kin CIO
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SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available) y - - � /- - ) - 7,-) 7ft
IH request to be notified when I can come to inspect the records) 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