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• <br /> 062 <br /> • <br /> C. OTHER SUBMITTAL REQUIREMENTS: <br /> 1 . Twenty—six (26) copies of the preliminary plat <br /> 2. Two full size copies of an Orange County Tax map . (one copy with tax <br /> parcels involved clearly marked) . <br /> 3. Where municipal or OWASA sewer is not available, a letter from the Orange <br /> County Health Department certifying the proposed wastewater system for <br /> each Lot . <br /> I, the applicant , hereby certify that the foregoing application is complete and <br /> accurate. I understand that a $210.00 fee (subdivisions of 15 Lots or Less) <br /> or a $370.00 fee (subdivisions of 16 Lots or more) is due at the time of <br /> application . A $5.00 per lot fee is due at the time the final plot is <br /> presented for recordation . <br /> 4110,ediv- /L .,._ _. <br /> APPLICANT'S SIGNATURE i NER 'S SIGNATURE <br /> 4/1_2J/r/g / . <br /> DATE' DATE __-- <br /> FEES: Amounts-11)414.7v D at e Paid d 1 331—�� Receipt pt / <br /> SGW <br /> I.. <br />