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SIGNATURES <br /> CITY OF6,44Er-S PLANNING OFFICIAL: <br /> Vere.c.t AvcfA.ev- <br /> (Print Name) P.Ari G OFFIC • .(Signature) <br /> 7 t9e3 <br /> DATE ADDRESss TELEPHONE# <br /> C2e_ '75q41 <br /> * COUNTY PLANNING.OFFICIAL <br /> (Print Name) PLANNING OFFICIAL(Signature) <br /> DATE ADDRESS . TELEPHONE# <br /> *If necessary,depending upon city/county agreement on jurisdiction outside city limits but within UGB. <br /> • <br /> • <br /> G:\FORMS\SEPTIC\S-39 LUCS.DOCX Rev:8/10,04/12,03/18 <br />