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<br /> <br />I <br />,II <br />fl <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I' <br />I <br />.1 <br />I <br />I <br />I <br />I <br />I <br /> <br />3 . SIGNATURE OF LOCAL GOVERNMENT OITICIAlS: The undersigned ~': have reviewed <br />the proposal for the location, construction, operation, and source of <br />potable water for the above-described water distribution facility, and RECOMMEND <br />APPROVAL or DISAPPROVAL in space provided below: <br /> <br />Recommend <br /> <br />Recorrnnend <br /> <br />DATE <br /> <br />APPROVAL <br /> <br />DISAPPROVAL <br /> <br />Signature for Local Health Departmem <br />or County Sanitarian <br /> <br />Signature for Board of County <br />Commissioners (If project lS In <br />an unincorporated krea) <br /> <br />Signature for Regional Planning <br />Representative <br /> <br />~':Before this application will be accepted for review, the applicant must show here- <br />on the action taken on the project by representative of the local health officials, <br />representative of the Board of County Commissioners (if applicable) the Mayor or <br />City Manager of the municipality or President of Water Utility and the Regional <br />Planning Official. <br /> <br />Signature and Title of APPLICANT (owner) <br /> <br />DATE <br /> <br />~ <br />