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_7 <br />_q T,— <br />w i. -Cou W_,�: - . - <br />­1. '_!= � �W <br />- Orange <br />_7�7 7 <br />VOW J., <br />I D <br />itrcs Board :. A ricult r <br />AS QUALIFYING FARMLAND <br />FOR7CERTIRCATION <br />CATION. .. . ...... ..... �t­- <br />­AND DESIGNATION <br />As AN ORANGE cOUNTY-_-.`_ RECEIVEDF� <br />­APR 0 9 199; <br />NOLUNTARY AGRICULTURAL' DISTRICT <br />INSrRUCnONS: Before completing the application, please review the provisions of dw Orange County Voluntary Farmlanci <br />y and completely as possible. Be sure to <br />out the form as accuratel <br />Preservation Program <br />Ordinance, Om fill <br />sign and date the form return it to the Orange County Inspections DepatUnent, 306F Revere <br />and retu planning & In <br />Load, Hillsborough, N.C. <br />APPLICANT: <br />Name• ' Victor-Carl Walters,'Jr. & Elizabeth T.-Walters <br />Address: 7119 High Rock Rd. <br />City: Efland <br />Phone Number: (Home) <br />PROPERTY INFORMATION: <br />State: N C <br />ZIP Code: 27243 <br />563-3842 (Work) <br />Property, Location/Address: 0 f f SR- 1346 <br />Township: 3 Tax Map: I Block: Lot: 7 <br />Parcel Identification'Number [PIN]: 9826-87-3901 <br />Deed Book: 4 51 : Page: 5 01 <br />Number of Acres:.::.. 8 8 9 8 4 2 <br />Does - this t . and have a plan on file with the Soil Conservation Service or U.S. Forest Service? <br />Yes: X 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: X No-, If "no", please complete back of form. <br />OWNER[S] CERTIFICATION: <br />i- [We],- the applicant(s)2- -hereby certify that, to the best of my [our] ability, the foregoing <br />application is complete and accurate. <br />Signature: 4:1& Date � <br />Signature: Date: <br />Please direct inquiries to: <br />Orange Soil & water Conservation District <br />cooperative Extension Service <br />Orange County Planning & Inspections Department <br />HW&wm& 732-819100upd KX 967-MIODwbm 699-M-1 1 =7-2MI <br />