Void, Void
\" I .' TOWN OF WAPPINGER
.... I APPLlCA nON FOR RECYCLE CENTER PERMIT Perm~ lisued
I vv'\b PERMIT' ~
RESIDENT INFORMATIO~,::;~:131
FIRST NAME ro' J4 J/ J' 0 : I MI U2J LAST NAME Lrc 0 G6 JI2.
STREET # lJ../ f I STREET NAME I CJ,L.[) /fo ~ U/ ~L- [lD I APT'I
~rrv'~~/~6~ n-~L.)~ I STA1E~ Zlpl/;'~o
HOME PHONE # I a'-J~--'~9r1)-cr-;)...try6-1 ~PHqNEI(optlonal).I'
OFFICE USE ONI. Y
RECEIVED BY
~I~..~~_.
o Chris Master.son
o
Olrlstlne Fulton
Sue ROH!
VEHICLE INFORMATION
VEHICLE' INFORMATION - -1/30. Veil> .-'
j)~(p
~ J ~t? IE!D I MODELl p/c.-/\ V et:-/st'1 YEAR l J tt 97
, ."
UCENSE PLATE' I q 9 ~(o 6 'J F I me OF YeiICLE 17R 0 l/K
.
VEHICLE 2 INFORMAnON ~ I J 3 / .
'- ..
. ,
MAKE 1.oL / vCoJ-y\;) I Mom} Lf ~p I YEAR I %2 oOS-
UCENSE PLATE # l )::J. z:. 7 ~ I ~-7' I TYPE OF VEHta.E l' I .
REQUIRED'Plldo~~ bF RESIDENCY/VEHICLE OWNERSHIP
~ POINTS P1.US REGlSTRA110N REQUIRED
. ~RNER'5 LICENSE I NON-DRIVERS ID 16 POINTS). D' MAlL FROM ANY GOVERNMENT AGENCY . (1 POINT)
I]'" VOTER REGISTRATION CARD (6 POINTS) Q BANK RECORDS BEARING ADDRESS 11 POINT:
~ TOWN TAX BILL (3 POIN75) D SUPERMARKET CARD'BEARlNG ADDRESS (1 POINT;
[J l1TIUTY BILL (3 POINTS)
C W2 or.2 recent pllyc:heck stUbs (3 POINTS)
tV'
VEHICLE REGISTRATION (REQUIRED)
Use of the Recyc:le Center Is limited toiown of Wappinger residents only. Residents are permitted "to dump trash ac:cumulated In'the
normal course of home-ownership. CommerdaJ use, to indude uses usodlted with rental property, lire not permitted. By signing below
you are swearing to be.! iown of WBppln,ger resident, 'to own'the vehlc:les listed on this 'form and '"to U5e the Recycle Gemerto dispose of
your.own traSh, accumulated in the normal co of home-ownership.
51GNATURE
DATI L/~6T"~LL ____
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