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grobinson ci)town91"wap pin c ny. ov or n`A i� i i"Vto 20 Middlebush. Rd Wappingers Falls, NY 12590
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FOR INTERNAL USE ONLY ')� 00 TOWN OF WAPPINGER
Public Access to Records
y: Joseph P. Paoloni R c.E
Received b E � tiJ -- , ,�i UEST
Lori McConologGte
Grace Robinson JA 1. (3' 201', a
Date Received: l
MOIL Ser.:
DEPARTMENT:
T:
ASSESSOR
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
RECEIVER OFTAXES
❑
RECREATION
SUPERVISOR❑
TOWN CLERK
0
WATER/SE\1IER
❑
DOG CONTROL. OFFICER
❑
TOWN ENGINEER.
TOWN ATTORNEY
0,
FOR DEPARTN4ENT USE ONLY
Date Received by Dept
Dcpartmcoit. Head approval:
Date Applicant Contacted:
Date FOIL, fulfilled or deeded:
Closed by:
Date:
Notes
Amount De Pages for a total of
Name: 66) ❑chcck here if you are
Address: ; - _ requesting that the records
ILA 1)r ,),I be nailed to this address.
Agency or firm:
Telephone #: mo'''t � FAX
Email address: (''1rl, ca, . "Ar ( ,;
SPECIFIC DESCRIPTION OF RECORD..
FORMAT OF RECORD (if available)
HIrequest to be notified when I can cone to inspect the record(s) described above
I request copies of the records described abovt� 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
I request that the records be faxed to the nunbtrr listed above