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( ) - (Telephone) (__) - (Telephone) <br /> ( ) - (Facsimile) ( ) - (Facsimile) <br /> APPROVED AS TO FORM: APPROVED AS TO FORM: <br /> BURLINGTON: <br /> By: <br /> CITY OF BURLINGTON <br /> Print Name: <br /> By: Its: <br /> Date: <br /> Print Name: <br /> Its: <br /> Date: <br /> NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: <br /> ( ) (Telephone) (j (Telephone) <br /> ( ) - (Facsimile) ( ) (Facsimile) <br /> APPROVED AS TO FORM: APPROVED AS TO FORM: <br /> By: By: <br /> Print Name: Print Name: <br /> Its: Its: <br /> Date: Date: <br /> NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: <br /> NPDES INTERLOCAL AGREEMENT <br /> Page 7 of 9 <br />