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Forms Can Be Submitted via Email to ImcconoIOgLie Leto wnofwappingerny.goy or
grobirisoncbtownofwappingerny.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni l
Dori McConologue
Grace Robinson
Date Received:
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
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RECEIVER. OF TAXES
I request to be notified when I can come to inspect the record(s) described above
RECREATION
I request copies of the records described above and agree to pay the cost of such records in
SUPERVISOR
accordance with the fee schedule on the back of this application
listed
TOWN CLERK
❑
WATER/SEWER
C]
DOG CONTROL OFFICER ❑
TOWN ENGINEER
❑
TOWN A'T'TORNEY
❑
Name:
Address:
Agency or firm:_
Telephone #:
Email address:
TOWN OF WA PIN GE
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blic Access to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept LlI /
Department Head approval:
Date Applicant Contacted: Ll I /
Date FOIL fulfilled or denied: L4 J I, �
Closed by:
Date:
Notes:
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Amount Due: Pages for a total of $ _5 a
rfu ��� w� � �A rzlP o check here if you are
.. a requesting that the records
_ be mailed to this address.
) 5o'5 .. ��/.._. � FAX #: ( �
SPECIFIC DESCRIPTION OF RECORD:
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
0
accordance with the fee schedule on the back of this application
listed
I request that the records be sent via email to the address above
❑
I request that the records be faxed to the number listed above
F-11 61so] F-111 LI I
Date Fee
04/25/2024
Town of Wpinger
20 Middlebush Rd.
Wappingers Falls, NY 12590
(845) 297-6256
�a*l OU -1111
Reference:
Maset, Alicia
3 New Rd
Check No. Receipt No. PayType Amount
VIMPI«� alvw I
This is a receipt for payment of fees. This is not a building permit.