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R <br />- - - - -;7 <br />grange Count �,,::�.=� <br />v <br />A rlcultural Districts Advisory Board-. <br />_.. <br />APPLICATION . ALIFYIN <br />GNATIO <br />ON FOR CERTIFICATION AS QU G F <br />_ <br />AND .DESIGNATION <br />N AS AN ORANGE COUNTY <br />VOLUNTARY AGRICULTURAL DISTRICT RECEIVED APR 0 9 1 <br />INSTRUCTIONS: Before completing the application, please review the provisions of the Orange County Voluntary Farmland <br />Preservation Program Ordinance, then fill out the form as accurately and completely ss possible. Be sure to <br />sign acid date,the forth, and return it to the Orange County Planning & Insp4oti01s Department, 306F Revere <br />Road, Hillsborough, N.C. <br />APPLICANT: <br />Name: victor Carl Walters Jr & Elizabeth T. Walters <br />Address: 71 19 H i h Rock Rd. <br />City: E f l a n d State: NC ZIP Code: 27243 <br />Phone Number: (Home) 563-3842 (Work) <br />PROPERTY INFORMATION: <br />Property Location/Address: N / 0 1340 <br />Township: <br />2 Tax Map: 4 2 Block: Lot: 1 1 <br />Parcel Identification Number [PIN]: 9836-19-5898 <br />Number of Acres: 8 4. 19 Deed Book: 2 2 0 Page: 19 5 `- <br />Does this land have a plan on file with the Soil Conservation Service or U.S. Forest Service? <br />Yes: X No: If "no ", please complete back of form. <br />Is this land listed for farm present use -value taxation with the Orange County Tax Office? <br />Yes: x Na: If "no ", please complete back of form. <br />OWNER[S] CERTIFICATION: <br />I_ [We]; the applicant[s],= hereby certify that, to the best of my [our] ability, the foregoing <br />application is complete and accurate. - <br />Signature: Date�L�(- ? _- / Tf <br />� y <br />Signature: /. a. Date: <br />Please direct inquiries to: <br />Orange Soil &Water Conservation District <br />Cooperative Extension Service <br />Orange County Planning & Inspections Department <br />Hilpbp w* 732.8181Kbrpel Hsi 967- MleDmrhsm 688.7031OMehom 227.2x11 <br />