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Forms Can. Be Submitted via Email to Imcconologue0townofwappingcrny.gov or
robir7son cDtownafweiny. ov or in person/via mail to 20 Ivliddlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P, Paoloni F]
Lori McConologue
Grace Robinson F
Date Received: r J
FOIL Ser, #:
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
TOWN CLERK
❑
WATER/SEER
DOG CONTROL OFFICER
TOWN ENGINEER
0
TOWN ATTORNEY
❑
Naive:) /a., r — �✓
Address: j � /�? _—'n" L Q_421
TOWN OF P Pr
Application for Public
FOIL REO
rk
-'N Building Departmant
WN bF
w. r.w
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department head approval: Tit,
Date Applicant Contacted: I /
Date FOIfulfilled denied: 9 1 l
Closed by:XLI&
Date:
Notes: jML'_P
Amount Due: Pages for a total of
check here if you are
requesting that the records
4 be mailed to this address.
Agency or firrn:
Telephone #: - 1-9 r AX #: ( -
Email address: ��r-c� .. _ - A—
SPECIFIC DES RIPTION OF RECORD:
FORMAT OF RECORD (if available) _ — (70&tO
HIrequest 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