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— -- <br /> r <br /> • <br /> Note: The application cannot be considered for filing until all of the above questions are answered and the fee paid. <br /> Do not write in space below—FOR DEPARTMENT USE ONLY <br /> Date of Application �� Fee Paid $ <br /> Permit Issued/Rejected (date) s• " 7 ' Permit Number <br /> Sanitarian(name) I. <br /> Form 2 5-18-70 DCEHD Revised 11-23-7 <br />