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Forrns Can Be Submitted via Email to ImcconotogueLttowiio,fwappingerny.gov or
grobinson Dwtownofwappingerriv,gov or in person/via mail to 20 Middlebush RaIWWA g s lj�,: �1)2
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FOR, INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Lori McConologue
Grace Robinson
Date Received
FOIL Ser. -9.
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
F]
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
— L REO' JEST
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Building Departinen't
Town of WappMger
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
it)
Date Applicant Contacted. -
Date FOI( fulfilled denied: /J/
Closed by:
Date:
Notes:
L 1//x -
Notes:
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Arnount Due-. — Pages for a total of $
Name: ncheck here if you are
Address: requesting that the records
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be mailed to this address.
Agency or firm: �2,)r'✓0' A,
Telephone 4:
5'FAX 47
Email addresszaLxLq
SPECIFIC DESCRIPTION OF RECORD:
FORMAT OF RECORD (if available) q,)c0cj
Irequest to be notified when I can corne 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
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