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Forms Can Be Submitted via Email to IrricconolO Lie wto
I _g L wriofixappingerriv.gov or
grobinsonCa towriofvappingerny.gov or In person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
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FOR INTERNAL USE ONLY
Received by: Joseph P. Paolom
Lori McConologue
Grace Robinson
Date Received. -
FOIL Ser. #f.
DEPARTMENT:
ASSESSOR
El
ACCOUNTING
Department Head approval:
CODE ENFORCEMENT
Date Applicant Contacted-.
HIGHWAY
❑
RECEIVER OF TAXES
D
RECREATION
n
SUPERVISOR
F-1
TOWN CLERK
El
WATER/SEWER
F]
DOG CONTROL OFFICER F-1
TOWN ENGINEER
E]
TOWN ATTORNEY
F-1
I I N Lit, Tj 112 K91
public Access to Records
IE OUEST
V 77 2t
Building Department
TOWN OF WAPPINGER
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted-.
H J -7❑ /9�5
Date FOIL fulfilled or denied:
-7❑ Jr
-
Closed by:
Date:
Notes:
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Amount Due:" — Pages for a total of $
Name: /97,rc 9,4,e de_A,514M��, )
Address-.
A,,t7encycar firm:
Telep!ione 9.
// V) C101v - S'yg'5 FAX 4:
F�check here if you are
requesting that the records
be mailed to this address.
SkECIF'1"E SCRIP OF RECORD:
FORMAT OF RECORD (if available)
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
I request that the records be faxed to the number listed above