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3 -17 -F7 3 <br />Orange County Agricultural Districts Advisory Board <br />APPLICATION FOR CERTIFICATION AS QUALIFYING FARMLAND <br />AND DESIGNATION AS AN ORANGE COUNTY <br />VOLUNTARY AGRICULTURAL DISTRICT <br />INSTRUCTIONS: Before completing the application, please review the provisions of the Orange <br />County Voluntary Farmland Preservation Program Ordinance, then rill out the <br />form as accurately and completely as possible. Please sign and date the form, and <br />return it to the Orange County Environment and Resource Conservation <br />Department, 306F Revere Road, Hillsborough, NC 27278 <br />APPLICANT: <br />Name: Robert E. Strayhorn <br />Address: 2103 New Hope Church Road <br />City: Chanel Hill State: NC Zip Code: 27514 <br />Phone Number (Day): 967 -1467 (Evening) <br />PROPERTY INFORMATION: <br />(1) New Hope Church Road <br />Property Location/Address: (2) Mincev Road. Walker Road <br />(1) Chapel Hill <br />Township: (2) Little River, Eno Map/Block/Lot: (1) 3..21: (2) 25..17.25..19 (LR). 8..1 (E) <br />Parcel Identification Number (PIN): <br />(1) 125 (1) 224 (1) 662 <br />Number of Acres: (2) 234 (LR): 196 (E) Deed Book: (2) 1074 Page: (2) 568 <br />Does this land have a plan on file with the Natural Resources Conservation Service or NC Forest <br />Service? <br />Yes: X No: If "No ", please complete back of form <br />Is this land listed for Present Use taxation with the Orange County Tax Office? <br />Yes: X No: If "No", please complete back of form <br />OWNERS] CERTIFICATION: <br />I [We], the applicant(s], hereby certify that, to the best of my [our] knowledge, the foregoing <br />application is complete and accurate. <br />Signature: Date: <br />Please direct inquiries to: <br />clo Orange County Environment and Resource Conservation Department <br />306F Revere Road <br />Hillsborough, NC 17278 <br />Hillsborough • 732 -8181 Chapel Hill • 967 -9251 Durham • 688 -7331 Mebane • 227 -2031 <br />