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Forms Can Be Submitted via Email to ti-nccoiio]O",Lie(ci,towiiofwapl)in ;gcriiy.t;ov or
7 " 611 to 20 Middlebush Rd Wappingers Falls, NY 12590
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FOR INTERNAL USE ONLY
15 vv n c) r V'-.11
Received by: Joseph P. Paoloni :- --1
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Lori McConologue
Grace Robinson
Date Received:
FOIL Ser. #:
DEPARTMENT:
Name: �Ao�c _."tot E]check here if you are
ASSESSOR
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ACCOUNTING
F-1
CODE ENFORCEMENT
[R
HIGHWAY
F-1
RECEIVER OF TAXES
❑
RECREATION
SUPERVISOR
❑
TOWN CLERK
1-1
WATER/SEWER
F-1
DOG CONTROL OFFICERF-1
TOWN ENGINEER
El
TOWN ATTORNEY
11
TOWN OF WAPPINGER
Public Access to Records
REOUEST
Building Department
Tc)vvn of wappinge,
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted: � 0 / 17?1 / 9c/
Date FOIL fulfi]led or denied: 10 IQLIQLI
Closed by: 61��//
Date:
to /C9❑I I -Dy
Notes: rei/le'uv'sk :±il'a- in aNLCrz-
Amount Due: — Pages for a total of $ —
Name: �Ao�c _."tot E]check here if you are
Address: requesting that the records
be mailed to this address.
Agency o r firm
Telephone 4: FAX #:
Email address: -o m
SPECIFIC DESCRIPTION OF RECORD:
4 LNh-C'ix 63
FORMAT OF RECORD (if available)
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
be to the listed
I request that the records sent via e-mail address above
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I request that the records be faxed to the number listed above