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Forms Can Be Submitted via Email to grobinson (d,)townofwappin -erny.gov or
in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590
Received
FOR INTERNAL USE ONLY
MAY 7076 (:SWT OF W APP"TN ER
Application for Public o
Received b Joseph P. Paoloni john of W ppgnger
Grape Robinson -Town Clerk FOIL REQ
MAY 15 1Z
Date Received:
FOIL Ser.
DEPARTMENT:
ASSESSOR.
❑
ACCOUNTrNG
CODE ENFORCEMENT
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HIGHWAY
RECEIVER OF TAXES
0
RECREATION
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SUPERVISOR
I request copies of the records described above and agree to pay the cost of such records in
TOWN CLERK
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
WATER/SEWER
❑
DOG CONTROL OFFICER ❑
TOWN ENGINEER
❑
TOWN ATTORNEY
FOR DEPARTMENT USE ONLY
Date Received by Dept
E3 I L_ ,
Department. Head approval:'
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Date Applicant Contacted:
Date FOIL fulfilled or denied:
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Closed by:
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Date:
Notes:
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Amount Due: Pages for a total of $
Name: :�T, )i f4,. ( "] �� check here if you are
Address: `] , ..- /? ,y. + P,, J G requesting that the records
be mailed to this address.
Agency or firm:
Telephone #: 4) Lj qu - FAX : { } -
Email address: —. a ) (AA LA C 4 1) � /�..'" a 41'rk
SPECIFIC DESCRIPTION OF RECORD:
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FORMAT OF RECORD (if available)
HIrequest
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