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REC -EIIWEB <br /> JUN 16 2021 <br /> SIGNATURES MARION COUNTY <br /> BUILDING INSPECTION <br /> CITY OF '� _\'cO\ PLANNING OFFICIAL: <br /> Mv��tAE_ <br /> (Print Name) PLANNING OFFICIAL(Signature) <br /> (o(1 2\ pe. xx B S, 563 4SLk 3`kgko <br /> DATE ADDRESS ©A\n,3`l2 TELEPHONE# <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 /> G:\FORMS\SEPTIC\Application Packets\S-39 LUCS.doc MC: S-39 rev: 8/10,04/12 <br />