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3 <br /> Arigai Orange County Agricultural Preservation Board <br /> APPLICATION FOR CERTIFICATION AS QUALIFYING FARMLAND <br /> AND DESIGNATION AS AN ORANGE COUNTY <br /> VOLUNTARY AGRICULTURAL DISTRICT/ <br /> ENHANCED VOLUNTARY AGRICULTURAL DISTRICT <br /> INSTRUCTIONS: Before completing the application, please review the provisions of the Orange County <br /> Voluntary Farmland Preservation Program Ordinance, and fill out the form as <br /> accurately and completely as possible. Please sign and date the form, and return it to <br /> the Department of Environment, Agriculture, Parks and Recreation <br /> PO Box 8181 -306 Revere Road, Hillsborough, NC 27278 <br /> APPLICANT: <br /> Name: eta.. PriC It,-. <br /> Address: 1 L. 143 . is v-c. <br /> City: ,yr I P pI;!IS State: ',t.. Zip Code: 27.!1i <br /> Phone Number(Day): 0/1) LLci-6320 (Evening)(9,473, -?44 f4 <br /> E-Mail: rc p aTiec-v-j2(? r- ;l o CO <br /> PROPERTY INFORMATION: <br /> Property Location/Address: <br /> Parcel Identification Number(PIN):4?7O3cC 733 Parcel Identification Number(PIN):997923L-SL. <br /> Parcel Identification Number(PIN):` go:3:' 2 Parcel Identification Number(PIN): <br /> Parcel Identification Number(PIN):'57?/3SL74 Parcel Identification Number(PIN): <br /> Parcel Identification Number(PIN):4362�'74/ .532 Parcel Identification Number(PIN): <br /> Parcel Identification Number(PIN): 'Sx rt'6S37 Parcel Identification Number(PIN): _ <br /> Number of Acres: oZq 3. 4"4 Deed Book: 4'Pag ` <br /> Does this land have a plan on file with the Natural Resources Conservation Service or NC <br /> Forest See? <br /> Yes: No: If"No", please complete back of form <br /> Is this land lifted for Present Use taxation with the Orange County Tax Office? <br /> Yes: v' No: If"No", please complete back of form <br /> I [WE]ARE SEEKING DESIGNATION AS A VOLUNTARY AGRICULTURAL DISTRICT t7.- <br /> I [WE]ARE SEEKING DESIGNATION AS AN ENHANCED VOLUNTARY AGRICULTURAL DISTRICT <br /> OWNER[S] CERTIFICATION: <br /> I [We], the applicant[s], hereby certify that, to the best of my[our] knowledge, the foregoing <br /> application is complete and acc ate. <br /> Signature: Date: 5,42. <br /> Signature: ,���h ■ Date: 9/42_ <br />