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PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATED ATE:PART I APPLICANT INFORMATION APPLICANT: CONTACT:PHONE:MUNICIPALITY:COUNTY: PART II SITE INFORMATIONDAMAGE CATEGORY KEY (use appropriate letters in
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Lycoming countyforms ampamp publications refer to the official forms and publications issued by Lycoming County for reporting purposes.
Entities or individuals required by Lycoming County regulations or laws to report certain information are required to file lycoming countyforms ampamp publications.
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