Orange County NC Website
NCDA &CS <br />ADFP Trust Fund <br />Agricultural Conservation Easements Application <br />For Agricultural, Horticultural, & Forestry Programs <br />Please direct all questions and concerns to: <br />Holly Gilroy <br />NCDA &CS <br />ADFP Trust Fund <br />2 W. Edenton Street <br />Raleigh, NC 27601 <br />919.733.7125 <br />Fax: 919.716.0105 <br />ncadfp(Q-ncmail.net ❑ www.ncadfp.org <br />Departmental Use Only <br />Date Received: <br />Application #: <br />Requested Amount: $ <br />Project Value: $ <br />All information in this application is required. Incomplete applications will be considered ineligible for <br />funding. <br />APPLICANT IDENTIFYING INFORMATION <br />Project Title: <br />(5 words or less; Must denote ownership) <br />Applicant Organization: <br />Applicant Tax Identification Number: <br />Applicant Contact and Title: <br />Applicant Mailing Address: <br />(if delivered by US Postal Service) <br />Street: P.O. Box 8181 <br />City: Hillsborough <br />State: NC <br />Zip Code: 27278 <br />County: Orange <br />Applicant Website Address (if applicable): <br />Applicant Email Address (if applicable): <br />Applicant Telephone(s): <br />County /Counties of Project Location: <br />Length of Time to Complete Proposed Project: <br />Breeze Farm Conservation Easement (Phase II) <br />Orange County <br />56- 6000327 <br />Rich Shaw, Land Conservation Manager <br />Applicant Physical Address: <br />(if delivered by any other means) <br />Street: 306 Revere Road <br />City: Hillsbrough <br />State: NC <br />Zip Code: 27278 <br />County: Orange <br />http://www.co.orange.nc.us/ercd/index.asp <br />rshaw @co. orange. nc. us <br />1- 919 - 245 -2590; 1- 919 - 245 -2591 <br />Orange County <br />4 months (or less) <br />APPLICATION MUST BE DELIVERED NO LATER THAN 5 :00PM ON DECEMBER 5, <br />2008. <br />Page 2 of 17 <br />Easement Application <br />