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SIGNATURES <br /> CITY OF PLANNING OFFICIAL: <br /> beef et O/a4einok <br /> (PrmtName) PLANNING OFFICIAL(Si <br /> gnatae) <br /> biz--11 i/ Mai Gb3 '5 � 3J <br /> DATE ADDRESS TELEPHONE# • <br /> *COUNTY PLANNING OFFICIAL • <br /> (Print Name) PLANNING OFFICIAL(Signature) <br /> DATE ADDRESS . TELEPHONE# • <br /> *Ifnecessary,depending upon city/county agreement on jurisdiction outside city limits but within UGB. <br /> • <br /> • <br /> • <br /> • <br /> GAFORMS\SEPTTC\S-39LIICS.DOCXRev 8/10,04/12,03/18 . <br />