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Forms Can. Be Submitted via Email to todell(cr)townofwa in ern ov or in person/via mail to 20 Middlebush
Rd. Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni 1
Lynn O'Dell 7
Lori MCConologrIe
Date Received:
FOIL Ser. #:
DEPARTMENT -
ASSESSOR
L
ACCOUNTING
L
CODE ENFORCEMENT
PLANNING
L
ZONING
U
FIRE INSPECTOR
LA
HIGHWAY
FI
RECEIVER OF TAXES
IL
RECREATION
L
SUPERVISOR
L
TOWN CLERIC
L
WATER/SEWER
L
DOG CONTROL OFFICER
Ll
TOWN ENGINEER
1
TOWN ATTORNEY
L
TOWN OF WAPPINGER
y Public A, sto Records
FOIL REQ
Bullding Do
TOW Partment
.ar
of P fir. e.
own Clerk
ru •r.
Date Received by Dept I " d l
Department Head approval:aInti-
0tr7t)_
Date Applicant Contacted: 2/0( f
Date FOIL fulfilled or denied: l ./2
Closed by:
Date:
Notes;
Amount Due: Pages for a total of $
Name: Z, Z .
Address: e., mis rc, ° e 07r
Ild 12-520
Agency or firm:
Telephone FAX #;
Email address: Liv ef �-? , Tk—
check here if you are
requesting that the records
be mailed to this address.
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
t 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 c -mail to the address listed above
I request that the records be faxed to the number listed above