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Forms Can Be Submitted via Email to linceonolo&Lic-�,to!,wilof,wappingcj-tiy.gov or
grobinson(&
townofwappingerny.gov or in person/ Viz'iAil fo'N Middlebush Rd Wappingers Falls, NY 12590
P
FOR INTERNAL USE ONLY w", TOWN OF WAPPINGER
APRI—icalim, fic Access to Records
Received by: Joseph P. Paoloili
0
Lori McConologue -1 I 9- UEST
Grace Robinson
Date Received:
FOIL Ser. 4:
DEPARTMEN rl,,
ASSESSOIZ
1:1
ACCOUNTING
0
CODE ENFORCEMENT
HIGHWAY
JZH.CEIVER OF TAXES
RECREATION
SUPHIZVISOR
❑
TOWN CLERK
WATT"R/SEWER
❑
DOG CONTROL OFFICER
El
TOWN ENGINEER
❑
TOWN ATTORNEY
Building Depart
Town of MW
FOR I'VE PAIUMENT USE ONLY
Date Received by Dept Q_ / _19, / 94
.. .... ... ....
Department Head approval: _cv_
(hilt)
Date Applicant Contacted-. tql 19/'W
"I
Date FOIL fulfilled or denied: I j / B
Closed by: &JmWO-11
Date:
Notes: C,0
'r's
Amount Due: — Pages for a total of $ -.
Name: [:]check here if you are
Address: C aI-Vm. -ds
requesting that the recoi
1 Q be mailed to this address.
Agency or firm:
Telephone ft: (fq 5 ),51 -7 53 FAX #:
Email address
SPECIFIC DESCRIPTION OF RECORD:
6 le t f f LI I) f, ( I? )A /j ('
FOIZMATOF RECORD (if available)
I request to be notified when I can come to inspect the record(s) described above
J request copies of the records described above and agree to pa, 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
1 request that the records be taxed to the number listed above