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SIGNATURES <br /> CITY OF S I l 1 V ekr c PLANNING OFFICIAL: <br /> . CLSOrt &Jo <br /> (Print Name) 'LANNLNG OFFICIA Signature) <br /> �• -Z 306 S Wot4ej S� so 3- X74 -Z Z ! Z <br /> DATE ADDRESSTELEPHONE <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 /> I1 <br /> G:'<FORMS\SEPTICIS-39 LUCS.DOCX Rev:8/10,04/12,03/18 <br /> , <br />