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6 <br /> ORANGE COUNTY LOCAL LANDMARK APPLICATION <br /> 12. APPLICANT/ CONTACT PERSON ! PREPARER <br /> Name Telephone Peter Sandbeck Orange County Cultural Resources Coordinator 919 245-2517 <br /> Address PO Box 8181 <br /> City/State Hillsborough Zip Code 27278 <br /> Signature c�/t�~ —� Date Nov. 22, 2022 <br /> E-mail; psandbeck@orangecountync.gov <br /> 13. This application is submitted (check one of the following]: <br /> XX at the request of the owner. <br /> with the owner's knowledge but not at his or her request. <br /> without the owner's knowledge. <br /> Return to: Cultural Resources Coordinator <br /> Orange County Department of Environment, Agriculture, Parks and Recreation <br /> P.O. Box 8181 <br /> Hi[Isborough, NC 27278 <br /> (919) 245-2517 <br /> 3 <br />