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02t <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 avai Lab le , 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 couplet. and <br /> accurate . I understand that a 1210.00 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 fins l. <br /> presented for recordation . plat is <br /> Paa,f-A2 <br /> AP121 ANT S SIGNATURE OWNER 'S SIGNATURE <br /> DATE <br /> 0....#77/g, 9 Z8 -� <br /> DATE <br /> • <br /> FEES: Amount ' 3 7u, Date Paid "7-2-1)7 Receipt //64I( <br /> • <br />