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10 <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 8181 (306 Revere Road) <br />Hillsborough, NC 27278 <br />APPLICANT: <br />Name: E / /S- = -1 Z_ <br />Address: c� 2- d <br />City: Cr- <br />a <br />State: c Zip Code: 2 �< <br />Phone Number (Day): (Evening): —3 14, Y <br />E -Mail: C-: fr iA-1 4,)& rc YYI <br />PROPERTY INFORMATION: <br />Property Location /Address(s): " ?ce& - 9LIoTt 0 a k Lij PL- Ll _-6 <br />Agriculture District /Township: e c aw <br />Parcel Identification Number (PIN): 6416`70C16 3 Acres , 4' he <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: <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 ( tkj=,� � '11 <br />Is the land enrolled in Present Use Value taxation program with Orange County Tax Office? <br />Yes: No: If "No ", please complete back of form <br />