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6 <br />aA,_20 i& <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 8981 (306 Revere Road) <br />Hillsborough, NC 27278 <br />APPLICANT: , , J <br />Name: M0,04 _5u� WOO�5 3AnSZ) <br />r <br />Address: "� �D C sck ),o X ]Rf. <br />City: (I f koro Stater Zip Code: 9�Q_7 <br />Phone Number (Day): Iq --730 ~ ' Ud3 (Evening ): <br />E -Mail: <br />PROPERTY INFORMATION: <br />Property Location /Address(s): 10a(1SDR R ±�LO L—EP,__ W06 S LCLn e_ <br />1 <br />Agriculture District /Township:L�(f Gt /�rSr <br />Parcel Identification Number (PIN); 9siv ZILIg70 Acres 1❑, 7zf <br />Parcel Identification Number (PIN): <br />Parcel Identification Number (PIN): <br />Parcel Identification Number (PIN): <br />Parcel Identification Number (PIN): <br />Parcel Identification Number (PIN): <br />Total Number of Acres on all tracts of land: qC7 '%z4 <br />Acres <br />Acres <br />Acres <br />Acres <br />Acres <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:— -V____� - No: If "No ", please complete back of form <br />