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4 <br />s • ,.COuI1 <br />Y _ - g _ <br />--.... <br />- - -- _ gricliltutal Districts Adwisoiy Board -.� <br />w.�... _.. <br />-7 9 :Ski: yY' _ "+;" �; _N _ _ �w-'•y +'x'`.' =,;� 1 40 - - - _ - e -r - ? <br />W � N FOR CERTCA TION A3QU ALFYIN G FAiRN ti II, = 'A'aN"' D- " <br />- <br />'AND DESIGNATION <br />Y_ <br />As AN <br />COUNTY•= RECEIV. _ <br />_ - 1994 <br />j r..... <br />VOLUNTARY AGRICUi.TURAI, DLSTRICT . �•.. APR 0 9 <br />INMUC nONS: Before completing the ucation, please review the provisions of the Orange County Voluntary Farntland <br />Preservation Program Ordinance, then fill out the form as accurately and completely as possible. Be sure to <br />- , - -_.. sign and date the form, and return it to the- ong County Planning l� tions D <br />epartment, 306F Revere <br />-' Reed, Hillsborough. N.C. <br />-' <br />APPLICANT: <br />Name:' Victor Carl Walters,• Jr. ' &'Elizabeth T. Walters <br />Address: 7 1 19 High 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: 0 f f SR 1 3 4 6 <br />Township: Tax Map 1 Block: Lot: 7 <br />Parcel Identification Number [PIN]: 9826-87-3901 <br />Number. of Acres -; 8 8 -.:,. =: <br />- _.... 9 8 4 2 Deed Book•.• 4 51 :. Page: _ 5 01 _ - - <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 No: It "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: - - Datd � L - / S 1 Z. <br />—r - <br />J ]� ' n <br />Signature• G(/akG�[.c.Y _Date: <br />Please direct inquiries to: _ <br />iOrange Soil & Water Conservation District <br />- Cooperative Emmion Service <br />Orange County Planning & Inspections Department <br />Hilbb*mu& 732- 8181•CWpd Hil1967-9751•Dmhm 66t- 7031•AI , '727 -2031 <br />