Orange County NC Website
Browse       Search
INSTRUCTIONS: Before completing the application, please review the provisions of the Orange <br />County Voluntary Farmland Preservation Program Ordinance, then fill out the <br />form as accurately and completely as possible. Please sign and date the form, and <br />return it to the Orange County Environment and Resource Conservation <br />Department, 306A Revere Road, Hillsborough, NC 27278 <br />APPLICANT: <br />Name: ~,.~ ~ t'id1 ~ ~- ~0. rtv~S ~-- ~-~ <br />/~/ /~ ~ ~? <br />Address: ~ ~l ~.. ~7`l " ~~/`t~"~-- ~--i~2~3G~C ~=--C~t <br />City: ~.:~/f~ C.~jZ~~-~ Z State:~~ __Zip Code: ~~ G- ~ <br />Phone Number (Day): C~1 ~ 7 ~~ - g 27~ (Evening) f ~, ? ~ 2 ~ `~ ~ 7 <br />E-Mail: <br />PROPERTY INFORMATION: <br />r /' ~ ~ <br />Property Location/Address: G ~' /2 ~~"~,h'`"'~ "~~' ~"~' C.ir2 `'~G I''-~` - <br />~/ _ <br />Township: (...~~ ~~- C~2~;'~ Tax Map: ~ ~ x ]r • ~ 5 Block: Lot: /~ ~• 5 ~ ,~ ~~~ <br />Parcel Identification Number (PIN): ~ ~ `'~ 1 "" ~ i3 " ~7(.v~ ~ , r <br />Number of Acres: ~ ~ .3'~~~ Deed Book:_ ~ a ~ _Page: ~ `T <br />Does this land have a plan on file with the Natural Resources Conservation Service or NC Forest <br />Service? <br />Yes: ~/ No: If "No", please complete back of form <br />Is this land listed for Present Use taxation with the Orange County Tax Office? <br />Yes: ~ No: 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] knowledge, the foregoing <br />application is complete and accurate. <br />""~~' ~~ <br />Signature: Date: <br />Please direct inquiries to: <br />do Orange County Envirot:n:ei:t mtd Resource Conservation Department <br />306F Revere Road <br />Hillsboro:rglg NC 27278 <br />Hil[sboroug/i • 732-8181 C1:apel Hill • 967-9251 Durham • 688-7331 Meba~:e • 227-2031 <br />