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Forms Can Be Submitted via Email to toddelIcc�,tqwnofwavT)in2erny,gov or in person via mail to 20 Middlebush
Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lynn O'Dell
Lori MCC011010gLIC
Date Received: / /
FOIL Ser. #: Lo
DEPARTMENT:
ASSESSOR E
ACCOUNTING E
CODE ENFORCEMENT 7
PLANNING F7
ZONING Ll
FIRE INSPECTOR F1
HIGHWAY E]
RECEIVER OF TAXES
RECREATION F1
SUPERVISOR L
TOWN CLERK 5
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
TOWN OF WAPPfNGER
Application for Public Access to Records
L REOUEST
EC
AW3 2 9' '?4224
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
(snit)
Date Applicant Contacted: 9A/'
�
Date FOIL fulfilled or denied:
Closed by:
Date: A 13 /,)L/
Notes: �_ sif �"e
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Amount buc: Pages for a total of
Name: K-1,O)d /a o ("--L-- � check here if you are
Address:
requesting that the records
i pa,_1_(LLLk., _L0 be mailed to this address.
Agency or firm,
Telephone #: �5' FAX ft.
-
Email address:
SPECIF11CDESCR TION OF RECORD:
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
L 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