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Forms Can. Be Submitted via Email to I.MccorIolo9uc(c),tOWIIOfWappin�;ertly, ov or
robinson ci;townotwapp n my Dov or in perso v° 1 O Middlebush Rd Wappingers Falls, DIY 12590
FOR INTERNAL USE ONLY - -'
Received by: Joseph P. Paoloni I~
Lori McConologue''I"Tow
Grace Robinson F
Date Received: /
FOIL Ser. ##:
17017171Mu101' 111
ASSESSOR
❑
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
TOWN CLERK.
❑
WATER/SEWER
❑
DOG CONTROL OFFICER
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
ation for Public Access to Records
Clerk FOIL REO VEST
15, �
BuHding D artMent
Date Received by Dept °f i
Department Head approval
Date Applicant Contacted: /SLI f d
Date FOI fulfilled Ir denied: IL) f ,, ; A_71.
Closed by:�-
,f
Date:
Notes:
Amount Due: Pages for a total of
Name: []check here if you are
Address: r -' ,%rte' 40 requesting that the records
, A)>/ZaEbe mailed to this address.
Agency or firm.:
Telephone #: (5`) - t,�l FAX #: ( ) _A_j-
Email address: .�,- s a2, t' C C4-1 1
SPECIFIC DESCRIPTION OF RECORD:
l j4 1 -r fir" I 7 t .� 1 h C P I d 4- 1%'l J 7 c- s kJy
FORMAT OF RECORD (if available)
IH request to be notified when I can come to inspect the record(s) described above
I request cop°res 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
❑ 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