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121 <br /> C. CTHER SUBMITTAL REQUIREMENTS <br /> 1 . TM erty-seen ( 27 ) copies cf -re preliminary plat . <br /> 2. T�'o full size copies of an Grande County Tax map ( one copy with <br /> tax parcels involved clea- ly narked) . <br /> 3 . Where municipal or OI'ASA sewer is not available, a letter from <br /> the Orange County Health Department certifying the proposed <br /> Mastewater system for each lot. <br /> I , the applicant, hereby certify that the foregoing application is <br /> complete and accurate. I understand that a S105 . 00 fee ( subdivisions <br /> of 1 -5 lots ) , S210 . 00 fee ( subdivision of 6-9 lots ) , S315 . 00 fee ( sub- <br /> divisions of 10-25 lots ) or a $420 . 00 fee ( subdivisions of 26 lots or <br /> more) is due at the time of application . A S5 . 00 per lot fee is due at <br /> the time the final plat is presented for recordation . <br /> (21.-"—c c.-z� C�� �� .UWLN. i <br /> APPLICANT' S SIGNATURE OWNER' S SIGNATURE <br /> DATE C��� <br /> DATE <br /> EE_S : Amount 30O d hi I2-G <br /> Date fi a i 3 - Receipt 51 3 <br />