Orange County NC Website
s <br /> Orange Counly Agricultural Districts Advisory Board <br /> APPLICATION FOR CERTIFICATION AS QUALIFYING FARMLAND <br /> AND DESIGNATION AS AN ORANGE COUNTY <br /> VOLUNTARY AGRICULTURAL DISTRICT <br /> t INSTRUCTIONS: Before completing Ne application,Pleux mime pPene4ions of tM orange <br /> main voluntary Fiordland Priervauna Pro Ordinance.Net Rn talk Rea <br /> forma:aemetely an,wmylNely os possible. Wean aqn an,date tM form,and <br /> ,urn it an Ne Omm,,DrentY�bnrentand <br /> NC�m CatervaMn <br /> oepanme t./JOdF Revere Road, <br /> APPLICANT: OpNFIO N. zatlascas J <br /> Nwna m ry G. Roc P) 7/e t0 Y 4i Ted ar5h: <br /> J <br /> /1 //. state—AA: 'p Code: 17278 <br /> Day' �� yny 7ya-7'12 DD <br /> Tl�.3 is Evenin 3 . 3 RL 6 <br /> PLOm Namr Past Y83 '4eI R2 m� el Y <br /> Email: TR„ _Tf: nFMC Pt^1'L'a'n <br /> PROPERTY INFORMATION: <br /> mn/Jddre,t: 38o d-a:Z3 5i aYS Rd N ii sbPra�yC <br /> We y 'nchlp-� Tar MOP. Block Ltc��I <br /> a �ga34 DV/b S69u°S <br /> Parcel taend6enitn Number(PMI: _u cases — '0 P <br /> i <br /> Nambcrof Acres°° Oced BOO4: n1�_Page. <br /> Ibrs this land have a plan on nit sack ibe Nawal Rceoorxs Conservation 5crvicem NCFOrest <br /> ls,mce? No I sal,',planes complete buck of form <br /> _ <br /> Yes: _ <br /> Ia this lmtl lutNfte Pte¢m UW taxation with ibe creep County Tax OMce? <br /> Y¢ lf..ii plw,e asse tc back Of to= <br /> OWNERM CERTIFICATION: <br /> I[A'e1,me sillicamla].hereby certify Nor,to me best If my[wr]kmader the foregoing <br /> application is wmplese and necumte. <br /> Signotute: <br /> /lyzes Dale: L- <br /> sienatarn: � 2v Ealc�1— <br /> Pleasedirect NyuiRmto: <br /> c/e Wynn Cnanry£nwmsw,11 dR.r e Cannoan Dpvmrvt <br /> ir a d <br /> nnkm.pk <br /> NC zma <br />