Orange County NC Website
Browse       Search
Orange County 3 <br /> Agricultural Districts Advisory Board <br /> APPLICATION FOR CERTIFICATION AS QUALIFYING FARMLAND <br /> AND DESIGNATION AS AN ORANGE COUNTY <br /> VOLUNTARY AGRICULTURAL DISTRICT <br /> INSTRUCTIONS: Before completing the application, please review the provisions of the Orange County Voluntary Farmland <br /> Preservation Program Ordinance, then fill out the form as accurately and completely as possible. Be sure to <br /> sign and date the form, and return it to the Orange County Planning&Lspections Department, 306F Revere <br /> Road, Hillsborough, N.C. <br /> APPLICANT: 4- 14-46 FD) <br /> Name: ,tn <br /> Address/: <br /> City: / State: Al,C ZIP Code: 2 <br /> Phone Number:(Home)_761 (work) <br /> PROPERTY INFORMATION: <br /> Property Location/Address: 3/ Oa,(lu�� IV s/Q //7`7 <br /> Township: Tax Map: Block: hot: tA4z,44 11-1 <br /> Parcel Identification Number [PIN]: q 8 51 -61- V06 <br /> N024 06 <br /> Number of Acres: 6 y 7 Deed Book: Page: �0 _ <br /> Does this land have a plan on file with the Soil Conservation Service 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: � No: If"no", please complete back of form. <br /> OWNERM CERTl>N'ICATION: <br /> I (We), the applicant[s], hereby certify that, to the best of my [our] ability, the foregoing <br /> application is complete and accurate. <br /> Signature: �'W ly�� Date: <br /> -- ---- <br /> --Signature: --- --------_-----------Date:------ ----- — -- <br /> Please direct inquiries to: <br /> orange Soil tit water Comervation District <br /> Cooperative Emnsion Service <br /> Orange County Planning&Empecdow Department <br /> HMAwm&732-3181•czl4 t®W7-9zs1"tom 6WIWI*Msb".2274M1 <br /> tmelit#1 <br />