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._. . 's 5 ii 4.3° <br /> �_ - , _ <br /> —=s _-- n _� =range County �- <br /> _ - _ <br /> Y .:.. <br /> Agricultural Districts Advisory Board <br /> ,.pr..a 4 vv- -... 2 1 s __. "�:c�".'=� °-cv'.rt :Qr. -tre'it-.>.• 1'._. __ . _ <br /> +;� <br /> .N._s ' -Y4 'p _- -- .. - <br /> . - °'APPLICATION FOR CERTIFICATION AS QUALIFYING IfA.RIVI ND <br /> AND DESIGNATION AS AN ORANGE COUNTY <br /> • VOLUNTARY AGRICULTURAL DISTRICT <br /> INSTRUCTIONS .Before completing the application, please review the provisions of the Ota-igc Cck,ity Voluntary Farmland <br /> Preservation Program Ordinance, then fill out the form u accurately and completely as possible. Be sure to <br /> _ sign and date the form,and return it to the Orange County Planning&Inspr ono Department, 306F Revere <br /> Road, Hillsborough; N.C. <br /> APPLICANT: Tierreich Farm <br /> Peter and Martha Klopfer <br /> --2---,..7----_-..-: Name: • g •:.• . .- Road - - <br /> ---Durham, NC 27705 <br /> - - --- Address: <br /> City: State: ZIP Code: <br /> PhoneNumber (Home) 3'3 3 Z 3 (Work) - ‘ f` _ 3 9 7/ <br /> . ----s._.r ;_ PROPERTY INFORMATION: // <br /> - Property Location/Address: <br /> _: <br /> - Township:. <br /> Cks/e/g <br /> Tax M ap Block: Lot: _ ' ✓. <br /> Parcel Identification Number [PIN]: 7/24. -e LC 77 !9 ?ii._ 20 <br /> - ' Number of Acres: a:fr•ax /0o. Deed Book. <br /> VI <br /> . - _ -• +act r. _ . . - : ,A'-:,,,- - ... <br /> - Does this land have a 1 file-with theLestiiii Conservati4Service or U.S. Forest Service? , <br /> . Yes: - ." No: -- - If "no", please complete back of form '- . - <br /> Is this land listed for farm present use-value taxation with the Orange County Tax Office? <br /> Yes: v' No: If "no", please complete back of form. <br /> OWNER[S] CERTIFICATION: w.I <br /> I�[Wel,411e_applicant(sl, hereby-,certify that,..to the best of my [our] -ability, the foregoing - <br /> ---2- <br /> �Y(�a4 2r p } :l <br /> a --c application is complete_and accurate.v, 4'-. <br /> /� 9 , <br /> _ r �f� Signature �� `"`Date: � L <br /> . 4 1. •'F.- -"f32-�.• .v - y.. _ _ �`fly f 14 .� :. <br /> yam% 2 v <br /> Signature /�i.:�� i` <br /> Date r Ja7 i <br /> `i--M .rates".'• i ..=.a. -i4f --..X` w.5L6S /_:L:t.- _ -- // �'4 _ - JS- _ _ <br /> T _ Please direct inquiries to _ <br /> Orange Soil&Water Conservation District <br /> Cooperative Extension Service - 7-1----z-.7 h Y Orange County Planning&Inspections Department t`°" <br /> q -- # -- = <br /> _`- z ,t j• inikeeogh 7324$1. .t i11967401•11veh"m 6111727-2031' _r - <br /> 7m1�lN.h.a. <br /> t +� s <br />