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R <br />APPLICATION FOR CERTIFICATION <br />AS QUALIFYING FARMLAND AND DESIGNATION AS AN ORANGE COUNTY <br />VOLUNTARY AGRICULTURAL DISTRICT <br />OR <br />ENHANCED VOLUNTARY AGRICULTURAL DISTRICT <br />INSTRUCTIONS: <br />Before completing the application, please review the VAD /EVAD brochure provided; <br />Complete the form as completely as possible; sign and date the form, and return to: <br />Gail M. Hughes <br />Orange County Dept. of Environment, Agriculture, Parks and Recreation <br />Soil and Water Conservation Division <br />P.O. Box 8181 (306 Revere Road) <br />Hillsborough, NC 27278 <br />APPLICANT: <br />Name: ' <br />Address: 3) 07 RC), <br />City:(.�cJcx a° Y-e) 'f - State: A)C_ Zip Code:'--) <br />Phone Number (Day): V %!f �r a Lf ., b (Evening): <br />FOXF1t11 <br />PROPERTY INFORMATION: <br />Property Location /Address(s):� <br />Agriculture District /Township: l- e C161- o-3% ►'� <br />��0: 9 a q <br />Parcel Identification Number (PIN): 2 '3 % Acres <br />Parcel Identification Number (PIN): <br />Parcel Identification Number (PIN): <br />Parcel Identification Number (PIN): <br />Acres <br />Acres <br />Acres <br />Parcel Identification Number (PIN): Acres <br />Parcel Identification Number (PIN): Acres <br />Total Number of Acres on all tracts of land: ) 0, <br />Does this land have a plan on file with the USDA - Natural Resources Conservation Service or <br />the NC Forest Service? <br />Yes: �/ No: If "No ", please complete back of form <br />Is the land enrolled in Present Use Value taxation program with Orange County Tax Office? <br />Yes: .1 No: If "No ", please complete back of form <br />