2025-373Nf d
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Forms Can Be Submitted via Email to lniccotiologtie(c�,towiiofwappiiigerny,gov or
grob,iiison�c�towtiofwappin�,)eriiy.,Ly,ov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
FOR INTERNAL USE ONLY TOWN OF WAPPINGER
Application for Public Access to Records
Received by: Joseph P. Paolom
UEST
Lori McConotogue
Grace Robinson
Date Received:
FOIL Ser. 4:
DEPARTMENT:
ASSESSOR
ACCOUNTING
❑
CODE ENFORCEMENT
HIGHWAY
FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the record( ' s) described above
request copies of the records described above and agree to pay the cost of such records in
accordance will the fee schedule on Ile back of this application
Irequest that the records be sent via e-mail to the address listed above
H I request that the records be faxed to the number listed above
RECEIVER OF TAXES
M
RECREATION
11
SUPERVISOR
E]
TOWN CLERK
1:1
WATER/SEWER
El
DOG CONTROL OFFICERF]
TOWN ENGINEER
El
TOWN ATTORNEY
11
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted
Date FOIL fulfilled or denied
Closed by:
Date:
(Imt)
&,2 /75 2Q
3
Notes: l et
Amount Due: a f a total of S r.
Name: A,J(vy Y4 / - Izx — Rcheck here if you are
Address: 73 requesting that the records
be mailed to this address.
Agency or firm:
Telephone 9: ("J' (7) 7 3_0 FAX 4:
Email address M i'–.
v -7d, � ---7 (Q) 4
SPECIFIC DESCRIPTION OF RECORD;
FORMAT OF RECORD (if available)
I request to be notified when I can come to inspect the record( ' s) described above
request copies of the records described above and agree to pay the cost of such records in
accordance will the fee schedule on Ile back of this application
Irequest that the records be sent via e-mail to the address listed above
H I request that the records be faxed to the number listed above