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Forms Can Be Submitted via Ernail to lrncconolo-t�L'52'townoI 1y.oy or
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,,rc)bitl,,, rnv.(-,,..ov or ill Person/via mail to 20 Middlebuash Rd Wappingers F Ils, NY 12590
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FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConologue,
Grace Robinson
Date Received'.
FOIL Ser. ft:
DEPARTMENT:
ASSESSOR
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
El
WATER/SEWER
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DOG CONTROL OFFICER
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TOWN ENGINEER
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TOWN ATTORNEY
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Name:
Address:
Application for Public
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Budding Department
TOWN OF WAPPINGER
USE ONLY
FOR DEPAR-T-M--E�Nl
Date Received by Dept�25
Department Head approval: Vin i t)
Date Applicant Contacted: Cf
Date FOIL fulfilled or denied:
Closed by: ilf
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Date: A
Notes:
Amount Due: Pages for a total of $
Agency orfirm:
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Telephone 52-�-4 FAX
Email address:
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
ocheck here if you are
requesting that the records
be mailed to this address.
0
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IE request to be notified when I can come to inspect the record(s) described above I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
fi,�t tlip f -mrd.-, be sent via e-mail to the address listed above