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Forms Can Be Submitted via Email to ImccorJ4,10go,,,(�)pa,,,��i,6of-,vappingeri-iy.gov or
groliinsoii(c�,towiiofvvappinger-nY2 -'ov or in person/via mail to 20 Middlcbush Rd Wappingers Falls, NY 12590
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FOR INTERNAL UST OWNOFWAPPINGER.
pplicationfor PUblic Access to Records
Received by: Joseph P. Paoloni
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Lori McConologue REUEST
Grace Robinson
Date Received: 2--A A�
FOIL Ser. #: "( &4
DEPARTMENT:
ASSESSOR
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ACCOUNTING
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CODE ENFORCEMENT
X
HIGHWAY
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RECEIVER OF TAXES
RECREATION
SUPERVISOR
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TOWN CLERK
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WATER/SEWER
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DOG CONTROL OFFICER 0
TOWN ENGINEER
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TOWN ATTORNEY
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FOR DEPARTMENT USE ONLY
Date Received by Dept (0/--
Department Head approval:
Vnit)
Date Applicant Contacted: 1C / / -21y
Date FOIL fulfilled or denied: 10 / 0� / -2Ll
Closed by: 1,111'I'lizzer
Date: _,g_q
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Notes: _ re V i eAWej Ti ie� Q --t f
Amount Due: — Pages for a total of $ —
Name: m(v3co, (Owl F-1 check here if you are
Address: j requesting that the records
be mailed to this address,.
Agency or firm:
TelephoneAX
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Email address: C,
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
Town Clerk
IH 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
F-� I request that the records be faxed to the number listed above