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C . OTHER SUBMITTAL RECUIRE LENTS : <br /> 13E <br /> 1 . Twenty—six [26 ) copes of the preliminary plat <br /> 2. Two full size copies of an Orange. County Tax map [one copy with ta) <br /> parcels involved clearly marked) . <br /> 3 . Where municipal or OWASA sewer is not avai lab Le , a letter from tha OrangE <br /> County Health Department certifying the proposed wastewater syste41 for <br /> each Lot,. <br /> I , the applicant , hereby certify that the foregoing application is complete any <br /> accurate . I understand that a $210.00 fee ( subdivisions of 15 Lots or leas' <br /> or a $370.00 fee [subdivisions of 16 Lots or more) is due at the time al <br /> app Licatf rsra . A $5.00 per Lot fee is due at the time the f''ina l plot i E <br /> presented for recordation .. <br /> 776.7-1 <br /> _ /f <br /> APPLICANT 'S SIGNATURE OWNER 'S SIGNATURE <br /> /e.e (//7 <br /> DATE / / DATE / <br /> • <br /> r • <br /> i;' <br /> � l <br /> J <br /> FEES: Amoun I . U Date Paid /2-6 16 Receipt /234Ip <br />