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- ' 5 <br /> C. OTHER SUBMITTAL REOU | AEMEhTS <br /> 1 . T‘Nenty-seven ( 27 ) copies of the prm | !m7rary plat. <br /> 2. Two full size copies of an Orange County Tax map (one copy with <br /> fax parcels involved clearly marked) . <br /> 5. 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 /> | , 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) 7s 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 /> ^« _ <br /> `^ � ���°°~� <br /> ' APPLICANT' S SIGNATURE w 'NERIS SIGNATURE <br /> ��- �_ � _ ��_ � <br /> � ^ » � . / � �_y <br /> DATE DATE <br /> FEES : Amount IK 20` 4/40 Date Paid /- / ^) ^g^� Receipt r7 Re0 / <br />