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Get Po Box 13446 Macon Ga 31208 Wastewater Form

07-1460 Fax (478) 207-1468 www.sos.state.ga.us/plb/water APPLICATION FOR REINSTATEMENT OF CERTIFICATION Reinstatement Fee: $165.00 Non-Refundable (Make payable to the GA Water/Wastewater Board) Please type or print clearly Enclose fee Use a separate Application for each lapsed certificate The Application must be received in the Board office at least 3 weeks prior of Board Meeting An incomplete Application will not be processed and will be sent back to the applicant Name :.

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