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i <br /> C. OTHER SUBMITTAL REUUIRENENTS: 08o <br /> I . 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 /> paresLs involved cLearLy marked) . <br /> 3. Where municipaL or OWASA suer is not avai Lab Leg a Letter from the Orange <br /> County HeaLth Department certifying the propoead wastewater system fo <br /> such Lot. r <br /> I , the appLlcanty hereby certify that the foregoing application 1s complet an <br /> e <br /> accurate, I understand that a 8210.00 fee (subdivisions of 15 lots or less <br /> or a 8370.00 fee (subdivisions of 16 Lots or more) 1s due at the time ai• <br /> application. A 86.00 Per Lox fee is due at the time the finaL plat is <br /> presented for recordation. <br /> PPLIdUNT's SIGNATURE OWNER'S' <br /> �l t �G <br /> DATE DATE <br /> FEES: Amoont 4 21 d Date Paid- Receipt AIM <br /> i <br />