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Farms Can Be 'Submitted via Email togrotinsonLtownofwappingerny.gov or
in person/via mail to 20 M:iddlebush Rc Wep ers Falls, NY 12590
Town of Wappir
Received by: Joseph P. Paolon%wn perk
Grace Robinson -1CT
Date Received: ❑ I
FOIL Ser. #: --
DEPARTMENT:
ASSESSOR
❑
ACCOUNTING
❑❑ J
CODE ENFORCEMENT
HIGHWAY
❑
RECEIVER OF TAXES
❑
RECREATION
❑
SUPERVISOR
❑
TOWN CLERK:
❑
WATER/SEWER
❑
DOG CONTROL OFFICER ❑
TOWN ENGINEER
TOWN ATTORNEY
Application for Public Access t0 Records
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FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:.
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Date Applicant Contacted: ❑ I / `"
Date FOI lfbiled or denied: 10
Closed by:
Date: ❑ Ir.. I°1„
Notes: r
Amount Due: Pages for a total of
Name: ( i-Ja" -, ❑check here if you are
Address: requesting that the records
I r, ,,J i r a rn " rh be mailed to this address.
Agency Telephone): ;() =❑ FAX
Email address:
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)"v, ." •'
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