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Forms Can Be Submitted via Email to lode] KI)tow . @Ay.gov or in person/via mail to 20 Middlebush
Rd Wappingers Falls, NY 12.590
FOR INTERNAL USE ON.
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Received by: Joseph P. Paoloni
Lynn O'Dell
Lori McConologue E t...
Date Received: I"
FOIL Ser. #:
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
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PLANNING
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:BONING
FA
FIRE INSPECTOR
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HIGHWAY
RECEIVER OF TAXES
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RECREATION
SUPERVISOR
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TOWN CLERK
WATER/SEWER
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DOG CONTROL OFFICER
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TOWN ENGINEER
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TOWN ATTORNEY
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AUG 2 7 2074
TOWN OF WAPPINGER
r 1p ion for Public Access to Records
n e� FOIL REQUEST
Date Received by Dept /�
Department Head approval:
It)
Date ,Applicant Contacted: /) /
Date FOI lfilled o dc;nicd:
Closed by:
Datc: f/:: 1,
Notes:
Amount Due: Pages for a total of
Naze: 1&7kr 8 check here if you are
Address: 3ick I .. W-3 requesting; that the records
be mailed to this address.
Agency or firm: ��
Telephone #: ( FAQ' #: { )
Email address
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available) ...
- R
00103
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