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~~ <br />1~ C N ~ YV P~LC~ <br />Oralage County Agricacltural Preservatio/7. Board <br />APPLICATION FOR CERTIFICATION AS QUALIFYING FARMLAND <br />AND llESIGNATION AS AN ORANGE COUNTY <br />VOLUNTARY AGRICULTURAL DISTRICT <br />INSTRUCTIONS: I3etm a completing the application, please review the provisions of the Orange <br />Cowtty Votuntary 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 Resow ce Conservation <br />Department, :306A Revere Road, Hillsborough, NC Z7Z78 <br />APPLICANT: <br />Name: Victor Carl Walters Jr & Elizabeth T. Walters <br />Address: 7119 Hieh Rock Road <br />City: Leland, State: NC Zip Code: 27243 <br />Phone Number (Day): 563-3842 (Evening) <br />PROPERTY INFORMATION: <br />Property Location/Address: N/O 1340 <br />Township: Cedar Grove Tax Map: 42 Block: 42 L.ot: 11 <br />Parcel Identification Number (PIN): 9836-19-5898 <br />Number of Acres: 84.19 Deed Boole 220 Page: 195 <br />Does this land have a plan on file with dre Natural Resowces Conservation Service or NC Forest <br />Service? <br />Yes: X No: If "No", please complete back of form <br />Is dais land listed for Present Use taxation with the Orange County Tax Office? <br />Yes: X No: If "No'", please complete back of form <br />OWNER[S] CERTIFICATION: <br />I [We], the applicant[s], hereby certify that, to die best of my [our] knowledge, dre foregoing <br />application is complete and accurate, <br />-U 3 <br />Signature: ~,~.g.~<-7,~., t. },t'c~..QL ~.~ Date: ~a " 3 ` O-3 <br />Please direct inquiries to: <br />do Ormige Cormry~ Em~ironuien(and Resanrce Carservation Deprtrlmen! <br />.306 Revere Road <br />Hiffsborongh, NC 27278 <br />Hillsborough • Z32-8781 Clmpcl !till •967-9257 Durlmm .688-7337 Tlebnu< • 217-20.31 <br />