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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: 7 LcfrS'Z� ffPilj ICS <br />City: 11,-1U -,tar 4 State. 1 rG <br />Phone Number (Day): ! 2 <S 3S/ (Evening): '?I � _732-- -74zV <br />E -Mail: Cdrrj <br />Zip Code: Z7 7_78 <br />PROPERTY INFORMATION: <br />Property Location /Address(s): '59.-We 4.5 <br />Agriculture District /Township: G'X-Ilc r�10-lelz- ` [!5,A ll& 47 6 i <br />Parcel Identification Number (PIN): QZ01• 03- §40Acres <br />Parcel Identification Number (PiN): - ! _ JoLj <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; -7� • / nc,- <br />Acres <br />Acres <br />Acres <br />Acres <br />Acres <br />zz, r <br />21 <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 V ue taxation program with Orange County Tax Office? <br />Yes: I1 ! No. If "No ", please complete back of form <br />