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Get PA PLCB-1708 2012-2024

UCTIONS ON REVERSE) 1.  NAME OF LICENSEE LId NO. 2.  TRADE NAME (IF ANY) LICENSE NO. 3.  ADDRESS OF PREMISES (STREET, RURAL ROUTE, P.O. BOX NO.)          (POST OFFICE)             (STATE)       (ZIP) TYPE OF MUNICIPALITY 4.  NAME OF MUNICIPALITY CITY TWP. BORO INC. TOWN COUNTY 5.  A.  PROPOSED NEW ADDITIONAL PREMISES ADDRESS DESCRIPTION DESIGNATED USE (SALES, STORAGE COLD STORAGE) NAME AND ADDRESS OF OWNER .

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