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w I <br /> C. OTHER SUBMITTAL REQUIREMENTS: 109 <br /> 1 . Twenty-six (20) copies of the preliminary plat <br /> 2. Two full size copies of an Orange County Tax map Iona copy with tax <br /> parcels involved clearly marked) . <br /> 3. Where municipal or OWASA sewer I. not available, a Letter from the Grange <br /> County Health Department certifying the proposed wastewater system for <br /> each lot. <br /> I , the epplicent, hereby certify that the foregoing application Is complete and <br /> saaursts. I understand that • $210.00 fee (subdivisions of 15 Lots or lees) <br /> or a $370.00 fee (subdivisions of 1H lots or more) is due at the time of <br /> application . A $5.00 per Lot fee is due at the time the final plat I . <br /> presented for recordation . <br /> 01J` 51 <br /> APPLICANT'S SIGNATURE ' NER'S SI :NATURE <br /> DATE DATE <br /> FEES: Amount � 66 Date Paid /- 36-0 Receipt 124109 <br /> • <br />