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There is a $110 annual fee for Businesses and a $25 annual fee for Day Care facilities, Non-profits, Government non-exempt and Park Districts.


  Facility Name:  
  Address:  
  City:  
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  Zip Code:  
  Phone Number:  
  Emer. Phone Number:  
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Main Contact Authorized to Close

  Main Contact Name:  
  Main Contact Email:  

Additional Closers Authorized to Close Facility

  Name:  
  Email:  
  Name:  
  Email: