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in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590 j
Received by: Joseph P. Paoloni El
Grace Robinson
Date Received -
FOIL Ser. #: 61):�- -
ASSESSOR
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CODE ENFORCEMENT
HIGHWAY
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RECEIVER OF TAXES
RECREATION
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER
TOWN ENGINEER
TOWN ATTORNEY
TOWN OF WAPPINGER
Application for Public Access to Records
tL REQUEST
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
Date �1704ftiffilled r denied -
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Notes: emd, ne9t AIeo
Amount Due: _ Pages for a total of $
Name: Vac Ejcheck here if you are
Address: r
requesting that the records
be mailed to this address.
Agency or
Telephone #: FAX #:
Email address:__
SPECIFIC DESCRIPTION OF RECORD:
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FOO U�4AT 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