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Forms Can Be Submitted via Email to lmccon6`4�i6: ` ofwappingerny.,gov or
grobinsonC(�)townofwappingerny,,i,,,ov or in person/via mail to 2, lebush Rd Wappingers Falls, NY 12590
J01 2 1 1411" I
Received by: Joseph P. Paolom
Lori McConologue
Grace Robinson
Date Received
FOIL Ser. 9.
DEPARTMENT:
MW
4 WV&
ASSESSOR
El
ACCOUNTING
CODE ENFORCEMENT
HIGHWAY
RECEIVER OF TAXES
EJ
RECREATION
E]
SUPERVISOR
TOWN CLERK
WATER/SEWER
DOG CONTROL OFFICER ❑
TOWN ENGINEER
TOW'NN ATTORNEY
❑
Public Access to Records
Name: ( 9vt �L
Address: 4i3e,t_� Po-&
13LOding L`�epzqrtnient
Town of WaPPIMIe"
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
Date Applicant Contacted:
Date FOIL fulfilled )r denied
Closed by:
Date:
Notes:
Amount Due: _ Pages for a total of S.
Agency or finri:
Telephone 4: (�Li j l l 06 �i FAX 4:
Email address: n - 6. )L
Elcheck here if you are
requesting that the records
be mailed to this address.
SPECIFIC DESCRIPTION OF RECORD:
Cera
..............
.... . . . ............. . ............
FORMAT OF RECORD (if available) 63 5T— 03- 0,46)3,�
IH 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 le-i-riall to the address listed above
I request that the records be faxed to the number listed above