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Ifl� <br />a ��t on nn ,,1�1A�11�� <br />Tlr�steenw 10 amft upon receipt of an application for a day care center, mini -day taro center, or group cars facility for <br />children. ............. . <br />43, <br />......9�one to Me applicant <br />...... . . <br />............2. 1M1�ilicis�aaartr,r�a this form for relicensinp unless there Is also a change of address for the facility.. <br />3. One copy of the completed <br />farm shall be forwarded to the appropriate local planningtzoning egencY, <br />and one copy shall be placed In the licensing file. <br />1 <br />D" f&Ie7 (ma) Br o% A40 <br />