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Forms Can Be Submitted via Email to Imcc011010t;ue(i�,WW22LN appin cr y. ov or
grobinson c�townofwa in ern xov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph. P. Paolon.i
Lori McConologue
Grace Robinson
Date Received:
FOIL. Ser. ##: f
DEPARTMENT:
ASSESSOR
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
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RECEIVER OF TAXES
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RECREATION
❑
SUPERVISOR
I request to be notified when I can come to inspect the record(s) described above
TOWN CLERK
❑
WATER/SEWER
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DOG CONTROL OFFICER [
TOWN ENGINEER
❑
TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
E UST
A P ! 1 6
F
FOR DEPARTMENT USE ONLY
Date Received by Dept 01,
Department Ilead approval:
Date Applicant Contacted: Icl
Date FOIL fulfilled or denied: 0 / r
Closed by:
Date: /7 1961
Notes: r ray P"
Amount Due: --Pages for a total of $ --
Name: la6e_ ❑]check here if you are
Address; requesting that the records
be mailed to this address.
Agency or firm:
Telephone ##: ('l!) - �?C FAX -
Email address:
SPECIFIC DESCRIPTION OFRERD:
A
9
�P
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.
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