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Get UT Health & Fitness Service Application Form 2013

______________________ Permit Number: __________________ ______________________________________________ Applicant’s Business Name ______________________________________________ Applicant’s Facility Name (DBA) ______________________________________________ Approved: _______________________ Exempt: _________________________ Denied: __________________________ Expiration: _______________________ Date of Application Please mark the appropriate box: INITIAL APPLICATION RENEWAL APPLICATION .

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