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Forms Can Be Submitted via Ernall to oi-
grobillso IL(�eliowilofNVLIP�Piligel-i.iy.L3ov or in person/via snail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paolom
Lori McConologue
Grace Robinson
Date Received:
FOIL Ser. 4,':
DEPARTMENT:
ASSESSOR
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ACCOUNTING
F-1
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
RECREATION
F-1
SUPERVISOR
❑
TOWN CLERK
WATER)SEWER
DOG CONTROL OFFICER El
TOWN ENGINEER
El
TOWN ATTORNEY
El
TOWN OF WAPPINGER
Application for Public Access to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted: 9 C93
Date FO111f�illcd r denied:
Closed by -
Date:
Notes:
Amount Due: Pages for a total of S
Name: Karla Rauch check here if you are
Address: ff 0-6 kf 55 requesting that the records
LaGrange NY be mailed to this address.
Agency or firin: Berkshire Hathaway
Telephone #: ( ) FAX,4:
Email address: krauch@bhhshudsonvalley.com
SPECIFIC DESCRIPTION OF RECORD:
23 Wild Turkey Run
X1 permits, and information on work done on 23 Wild Turk6yIR_u_n__
FORMAT OF RECORD (if available) '`io- -5
, 3 COW
IH 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
7_71 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 number listed above