Cracco, StevenGarage Sale Kermit application
Return to: Town Cierk
Town of Wappinger
20 Middlebush Rd,
Wappingers Falls, NY 12590
Name: jc"Co -7—eve's
asl
Address: 1 0 5®)0
treet Tess
P
Wa�in ers Falls, NY_ 12590�i�r
(city) (s -r) (Zip) gel
Phone: 1 35
O\l
Address Of Sale: treet Tess
(If different from above)
Wa invers Fal1s,NY 12590
(Ciry (ST) (ZiP)
l
Date of Sale: _ .From:amlprn) until ��� {alnl�n}
(D 2y
it, f, egtn) ('1 [M -76E)
From: ��(am/pin) ltntil � (anllpin)
(�aV'1'wo (rule egul)
r Froin: � ROJ (amlpm) until {am/pin
(1DEq T rte) (7171, e eguz Time E )
Sign: 4 -%4Date. �
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni ❑
Grace Robinson ❑
Date Received:
Serial #:
