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VOLUNTARY AGRICULTURAL DISTRICT <br />INSTRUCTIONS: Before canpleting the application, please review the provisions of the Orange <br />County Voluntary Farniland Pr°eservation Program Ordinance, llren fill out the <br />form as accurately and completely as possible. Please sign :md date the form, and <br />return it to the Orange County Environment and Resow ce Conservation <br />Department, .30GA Revere Road, Hillsbm ough, NC 272'78 <br />APPLICANT: <br />Name: Victor Carl Walters Jr. & Elizabeth T Walters <br />Address: 7119 High Rock Road <br />City: Efland. State: NC Zip Code: 27243 <br />Phone Number (Day): 563-3842 (Evening) <br />PROPERTY INFORMATION: <br />Property L.ocatiot>/Address: N/O Hieh Rock Road <br />Township: Cedar Grove Tax Map: 42 Block: 5 Lot: 5 <br />Parcel Identification Number (PIN): 9837-03-2356 <br />Number of Acres: 45.33 Deed Book: 206 Page: 189 <br />Does this land have a plan on file with the Natural Resources Conservation Service or NC Forest <br />Service? <br />Yes: X No: If "No", please complete back of form <br />Is dis land ]fisted 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 the best of my [our] lrnowledge, the foregoing <br />application is complete and accurate. <br />is-~-r~~ <br />/a-3 ~~ <br />Please direct inquiries to: <br />do Omuge County Errnironrnent and Resnnrce Conservation Departmen( <br />306A Revere Rnad <br />Hilfsboraugb, NC 27278 <br />Hi[fsbarougb • 732-8181 Cbrspef Iii!! • 967-9251 Onrbrsm • 688-2331 Alcbmrc • 227-2031 <br />