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O9 <br /> C . OTHER SUBMITTAL REGUI REMENTS : <br /> /1 . Twenty–six (26 ) copies of the preliminary plat <br /> ✓ �. Two full size copies of an Orange County <br /> parcels involved clearly marked) . <br /> Tax map. (one copy with tax <br /> 3 . Where municipal or OWASA sewer is not available , 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 complete and <br /> accurate . I understand that a $210.00 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 final plat is <br /> p .essnted for recordation . <br /> -7 i <br /> APPLICANT 'S SIGNATURE :'2�• -�- �-c'r' ��'G°J <br /> OWNER 'S SIGNATURE <br /> /Z /G y t..1— 31- 7 <br /> DATE DATE <br /> FEES: Amount 11.--'ir , ! Date Paid � _?c <br /> _ --�� Receipt -4:7 '1- <br />