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Forms, Cary Be Submitted via Ernail to lnzc.conolo '—:,;tovvnol��w ap�n�xern �.�ov or
r�robins rr�` r towrrc fwwa1)RnIern I.�10 ' or in persoti)vra mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConologUe se
Chace Robinson -
Date Received: _
FOIL Ser. #: a 0` -
DEPARTMENT,
ASSESSOR
ACCOUNTING
CODE, ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
C�
RECREATION
SUPERVISOR
TOWN CLERK.
WA.TERISEWER
:DOG CONTROL OFFICER
D
TON N ENGINEER
El
TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
d MEWED
_ - Building Department
TOWN OF WAPPINGFR
...
FOR DEPARTMENT USE ONLY
Date Received by Dept 1
Department head approval:
(rr�it
Date Applicant. Contacted: 9 1 L( / 9
Date FOIL fulfilled or denied: 1 /
Closed by:
Date: A l q /
Notes,rr r
Amount Die: Pages for a total of $ «--
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Name: " "t 4 requesting that the records
Address: / be mailed to this address.
Agency or firm: w
Telephone # { 2 FAX ( -
Email address: [ c
SPECIFIC DESCRIPTION OF RECORD
M
FORMAT OF DECOR -D (if available)
1request to be notified when I dan come to �andect the
agree to play be colst of ed �uclr records in
ove
I request copies of the records escr: bed above
r' accordance with the fee schedule on the back of this application
r1,,At thf- records be sent via e-rnail to the address listed above