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This form must be completed in accordance with section 5. 10 of our Sewer Use Ordinance NC Model Section 5. To the Best of my knowledge the information on this form is true and accurate Print Name Signature Title Date Return this form within 30 days to Shanell Thomas Wastewater Compliance Supervisor South Granville Water and Sewer Authority Email sthomas sgwasa.org 415 Central Avenue Suite B Butner NC 27509 Failure to return this form is enforceable in accordance with the Sewer Use Ordinance....
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