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loq. <br /> C. OTHER SUBMITTAL REQUIREMENTS: <br /> 1 . Twenty—six (281 copies of the preliminary plat • <br /> 2. Two full size copies of an Orange County Tax map (one copy with tax <br /> parcels involved cLearty marked) . <br /> 3. Where municipaL or OWASA sewer is not avai lab La, 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 comp Leta and <br /> accurate. I understand that a $210.00 fee (subdivisions of 15 Lots or Less] <br /> or a $370 .00 fee (subdivisions of 18 Lots or morel is due at the time of <br /> application . A $5.00 per Lot fee is due at the time the final- plat is <br /> presented for recordation . <br /> A" - LICAN r 'GNATURE OWNER 'S SIGNATURE <br /> rzli <br /> DATE DATE <br /> • <br /> FEES: Amount //AS Date Paid 1f-,2S-i‘ Receipt //5c3 <br />