2025-241Mole,
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Forms Can Be Submitted via Email to Imcconologoe(a?townofwappingerny.gov or
robin.son(a),townofwappi.ng_e1;ny, oo or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni C
Lori McConologue
Grace Robinson J
Date Received:
FOIL Ser, #: — I
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
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CODE ENFORCEMENT
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HIGHWAY
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RECEIVER OF TAXES
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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
RECREATION
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SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICERE]
TOWN ENGINEER
❑
TOWN ATTORNEY
❑
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TOWN OF WAPPRI GER
Application for Public Access to Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept / t 1 202-S
Department Read approval:T
Date Applicant Contacted: / A / 202S
Date FOIL fulfilled or denied: / / &Z
Closed by: kNa3w
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Date: /Al-` 1 W2S
Notes: �1-e Abwwe 1 _
Amount Due:
Name: 9 oc,ri t t V_ —2— ❑check here if you are
Address: odV V)i1j requesting that the records
t o be mailed to this address.
Agency or firm:
Telephone #: ( ) q -1�% FAX #: ( ) -
Email addi ess: _ —tyd n 53 0 q 0 h +M 1,
SPE ,IFIL ESCRIPTION OF RECO
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FORMAT OF RECORD (if available)
3request 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
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