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OFFICE USE ONLY
RECEIVED BY
TOWN OF WAPPINGER
APPLICATION FOR RECYCLE CENTER PERMIT
I Submifby Emaill
r Christine Fulton
Jessica Fulton
r Sue Rose
Permit Issued
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FIRST NAME
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RESIDENT INFORMATION
LAST NAME I.... Sp\"\<.J(~
PERMIT 1 I (q
PERMIT 2/
STREET NAME
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STREET # t ... .~.
CITY I \Jf;q~P141.r~1<.. rA~L S
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APT# 1
ZIP 1 I~ [lo
HOME PHONE # I .. .1(0, 'I/rl(
VEHICLE 1 INFORMA rlON
CELL PHX Plio I) I
@RMATION
MAKE I ~~~yf{()~~r-
MODEL L Jt"yalt()6
YEAR L~L?91~
LICENSE PLATE # L CS J ?? g 71
TYPE OF VEHICLE I~"-I.((,)e
VEHICLE 2 INFORMA rlON
MAKE 1
MODEL I
YEAR
LICENSE PLATE # I TYPE OF VEHICLE I
REQUIRED PROOFS OF RESIDENCY I VEHICLE OWNERSHIP
r DRIVER'S LICENSE / NON-DRIVERS 10 (6 POINTS)
r VOTER REGISTRATION CARD (6 POINTS)
r TOWN TAX BILL (3 POINTS)
r UTILITY BILL (3 POINTS)
r W2 or 2 recent paycheck stubs (3 POINTS)
6 POINTS PLUS REGISTRATION REQUIRED
r MAIL FROM ANY GOVERNMENT AGENCY (1 POIND
r BANK RECORDS BEARING ADDRESS (1 POIND
r SUPERMARKET CARD BEARING ADDRESS (1 POIND
r VEHICLE REGISTRATION (REQUIRED)
Use of the Recycle Center is limited to Town of Wappinger residents only. Residents are permitted to dump trash accumulated in the
normal course of home-ownership. Commercial use, to include uses associated with rental property, are not permitted. By signing below,
you are swearing to be a Town of Wappinger resident, to own the vehicles listed on this form and to use the Recycle Center to dispose of
your own trash, accumulated in the normal course of home-ownership.
SIGNATURE I '"i(''-W1M W ~ 0~
j
DATE I I ~ J ~3 JAV ft