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Forms Can Be Submitted via Email to lmccotiologue(tc towiiof�&apL)ingerciygov or
t•obinson�c"i)to�vnol'wappini�,erny.gov or toperson/via mail to 20 Middlebush Rd Wappingers,F411s, NY 12590,
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FOR INTERNAL USE ONLY TOWN OF WAPPINGER
Application for Public Access to Records
Received by: Joseph P. Paoloni -1
Dori McConologue -1
Grace Robinson
Date Received:
FOIL Ser. #f:
DEPARTMENT:.
ASSESSOR
IFI ESC IPTION OF CORD:
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ACCOUNTING
F1
CODE ENFORCEMENT
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HIGHWAY
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RECEIVER OF TAKES
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER �]
TOWN ENGINEER
TOWN ATTORNEY
❑
FOIL REQUEST
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Building Department
Town of Wappinger
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
1
Date FOI fulfilled denied: °
Closed by:
Date:
Notes: Lou /Mc6—)
Amount Due: / Pages fora total of
Name: VGGA ".;ii ®check here if you are
Address: _ ra requesting that the records
be mailed to this address.
Agency or firm: t,
Telephone #: FA #: )
Email address:
SP
IFI ESC IPTION OF CORD:
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FORMAT OF RECORD (if available) /; ?579 _6 _ 71 � I
I 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
❑ I request that the records be sent via e-mail to the address listed above
1 request that the records be faxed to the number listed above