2024-111Received by: Joseph R Paoloni E
Lori McConologue
,Grace Robm'sorl _j
Date Received:
FOIL Ser. 11:
DEPARTMENT.
ASSESSOR
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ACC(YLJN`fI1gid' G
CODE Ell,\IPORCEMENT
"HIGHWAY
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RE CEIVER 1,"" U--
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F.1',`.CREATION
SUPERVISOR
TOWN CLERK
ED
WATEWSEWER,
El
DOG C(.-)NfROI, OFFICER
TOMINENGINEER
TOWN ATTORNEY
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Application -for Piiblic Accuss, to Records
T-17OUL REOUEST
ce
,e x\ied
M
Date Receive(l by Dept
Departinent Head approval:
Date Applicant Contacted
W
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DateFOR, fulfilled or de'nied: Is O_X4
Closed by:
RM
5/1 /'
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Notes - s qcJ - _j
Amount Dae _,' Pages for a total of
Name--
-A-? — Elcheck here if you are
Addruss-
---- — -- requesting that the records
lie mailed to this addi,-ess,
Agency or Eim:
Telepbone:#:
FAX#-
Einail aftess:
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available)
I request to be notified when I can corns to inspect the record(s) described a,bove
H I I request copies of the records des cribedaboar e and agree to pay the cost of such records in
accordwice with the fee schedule on the back of this application
I request that the records be sent via e-mail, to the adch-ess listed above
I request that the records be faxed to the number listed above
MAY 01 2U�24
Building Department
TOWN OF WAPPINGER