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Forms Can Be Submitted via Email to ImcconolOgLtect,tOwnofvvappingern y,Eov or
Ltobinson cb ownofwappinggRyg2v or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 71
Lori McConologue R"'
Grace Robinson E�
Date Received:
FOIL Ser. #: 0
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
F�
RECEIVER OF TAXES
El
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
❑
DOG CONTROL OFFICERF�
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
TOWN OF WAPPINGER
P.C600lication for Public Access to Records
t)1*30-ftiont
M4 PP ilk
I I 111"MIWEP
FOR DEPARTMENT USE ONLY
Date Received by Dept 13,' Vy
Department Head approval:
Date Applicant Contacted:
Date FOI e!!d or denied:
Closed by:
Date:
Notes:
/ /S / d6j-'�
Amount Due: _ Pages for a total of S.
Name: V ii c f T,, t4 � � as r-Icheck here if you are
Address: 14 b, it t &Y'i requesting that the records
,nff p zS-3 3 be mailed to this address.
Agency or firm:
Telephone #:
Email address:mut
7�_5 g,�-75 FAX #:
0 ejq 6� 9 P" a; V C_ 0 Yh
SPECIFIC DESCRIPTION OF RECORD:
37 i
4'j"3 V;
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
F-1 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