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016 <br /> C. OTHER SUBMITTAL REQUIREMENTS <br /> 1 . Twenty-seven ( 27 ) copies of the preliminary plat. <br /> 2. Two full size copies of an Orange County Tax map ( one copy with <br /> tax parcels involved clearly marked) . <br /> 3. Where municipal or OWASA sewer is not available, a letter from <br /> the Orange County Health Department certifying the proposed <br /> wastewater system for each lot. <br /> I , the applicant, hereby certify that the foregoing application is <br /> complete and accurate. I understand that a $105 . 00 fee ( subdivisions <br /> of 1 -5 lots) , $210 . 00 fee ( subdivision of 6-9 lots ) , $315 . 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 $5 . 00 per lot fee is due at <br /> the time the final plat is presented for recordation. <br /> G <br /> !Y 6 f 1 SfI <br /> PPLICANT' S SIGNATURE OWNER' S SIGNATURE <br /> Y/—?//8 <br /> DATE DATE <br /> FEES : Amount +a(d ' ob Date Paid 7-3L-s7 Receipt 94-0625 <br />