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<br />       												- 			-._,_     f21A-1-       1'141
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<br />       								Agricultural Districts Advisory Board
<br />    								•-.-     -    ,    -
<br />										STAFF CITECKLIST FOR
<br />  							VOLUNTARY AGRICULTURAL DISTRICT SELECTION
<br />    												-:-: DateApplicationReceiveci:
<br /> 						---
<br />   						_,, ..
<br />				APPLICANT NAME:  3-c:=4-11-4     24 t=4 V_  1.4.01zIzi
<br />				PROPERTY INFORMATION:			..
<br />   					•Property LcvationJAddress:   '52..  cq se,      F.A012...er,v....1     ./1„11--L,   T2106-1CD
<br />   					•Township; tb($-V061 .s.t41  	Tax Map: 	(    __ Block:	---       Lot:
<br />   					•Parcel Identification Number [PIN):    41-va     on     Cp 3-7 5
<br />   					•Number of Acres:       -74 .1 5 CS i=a 80   Deed Book:       (2.4  		Page:
<br /> 				CERTIFICATION CRITERIA REVIEW:
<br />      				...,    •Meets acreage requirements of:  	-      so   --
<br />      						DI       One farm containing at least 110 contiguous acres; OR    			6/1u
<br /> 								Yea:    		No:       `il.   	lnitials:pr_,61E-    	Date:
<br />       						[2]       Two or more contiguous farms containing at least laCC-res.
<br /> 								Yes:    		No:	Y-  	Initials:   M -C---,	Date:  Wi is i
<br />  				•
<br />    					•Participating in farm present use-value taxation program.
<br />     					Yes:    		No:    		Initials:       l'nE,C      Date:
<br />    					•Certified by Soil Conservation Service as to land suitability.
<br />     					Yes:      `/-   	No:    		Initials:       frIrr     Date:  	2-A   ('9
<br />  				•   '
<br />     					•Managed in accordance with SCS defined erosion control practices.
<br />     					Yes:      N4   	No:    		Initials:       Yrip C..   Date:  	2- /l    i
<br />  											,A
<br />  				CERTIFICATION/DESIGNATION ACTION:     _ : _
<br /> 																	..  			..
<br />						_   .										-  		Date
<br />    															•
<br />   				-----
<br />      			—--  . -  -  •Application reviewed for completeness. -   -- --  - --,
<br />       			.    _
<br />   			- - .  - -     -.-*Application forwarded to   				-
<br />     									-Tax Supervisor's Office.     					/2.-7/.1--
<br />				.... .. ..  .      	,
<br />    				- ---   				-Soil Conservation Service.  					) 2.1
<br /> 					:		-.
<br />      					•Evaluation received from
<br />     									-Tax Supervisor's Office.    					/2"T (  3
<br />					'It.-_   				- Soil Conservation Service.					2...)    ) g.
<br /> 			TT-T..':-_'-',..-_-      •Application presented to Agricultural Advisory Board.  					.77/i"5/9.."
<br /> 				--  -,- -•   -  ., [1]  •Qualifying farmland certification approved.     Yes:	No:
<br />  		-,---,.----':,-- -1.--.,---_,,,-:,':4:11,      ;:...i;':•;-_-,t7 ,-.-m.
<br />      					7-,...:.. -7 :  nellia0n:
<br />      					.-  :121...Recommendation for district designation approveti..Yes:     No:
<br />							'Reason:       	-  •   '  •-    ---- •"1-'---,--
<br />   			=1E:-...7     ::.......71-..  ..:.;-*Application presented to Board of Commissioners.:,-...      ..   _
<br />    		,   ••  :1-.....5-.-!7':":::75r..747r.K-',Fr-'7E.`:.
<br /> 							Agricultural district designation approved.-...    Yes:	Na:  	•
<br />  				— ,
<br /> 			.,..,---,--_,,,,..,__::•:_7!:-.,:_z2:7.11--.::.1:.,-..;,7::..;:-.:,7 ReALson:
<br />   						121'...Conservation agreement form/content approved,Yes:       No:
<br />    		• -       .---7----64--'------•-75:;-'4
<br />     			• • ,--4 ---............7-,....-*Conservation agreement signed/recorded,
<br />      					-*Agricultural district identified in Land Records System..  ....--	'
<br />       				- - -
<br />       					•Agricultural district identified on Tax Map.      	__.
<br />     			- 		.Agricultural district sign[s]
<br />  												•   •     • -_-
<br />      		-_  ----T-7,-,-:-.:77-,:'..-- :,"-7 7_':'-..' ..-.- 7..Tr.".-.--     ■ -      							'
<br />      														,.      --' 	' ' -: .- --.... ■.--.7':--;:::::t.7 7.7-    7._
<br />     		-.    :--.."..._'..r... ) '■ 2:1-. .. • ...,   .-     		-  7-
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