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Notary Public Official Signature SEAL Notary Public Printed Name My commission expires Pursuant to 21 NCAC 34A. Signature in full of Applicant Sworn to and subscribed before me by this the Name of Applicant day of. A completed renewal application and fee of 75. 00 for the 2017 permit are due by December 31 2016. Renewal applications or fees received after February 1 2017 must include a 50 late fee. The applicant understands that should a permit be granted it may be revoked or suspended...
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