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4 <br /> Certification and Signatures <br /> I certify that, to the best of my knowledge, the information contained above, and in the supporting <br /> documents, is a factual representation of the proposed development. <br /> I acknowledge that by signing this application, the Orange County Planning and Inspections <br /> Department is authorized, pursuant to NCGS 160D-403, to make as many inspections of the subject <br /> property as may be necessary to verify that the proposed work outlined herein is consistent with the <br /> provisions of all applicable State and local laws, ordinances, and regulations. <br /> By signing this application, I acknowledge and agree that inspectors, zoning officers, erosion control <br /> officers, and other staff of the Orange County Planning & Inspections Department have a right, upon <br /> presentation of proper credentials, to access the subject property at a reasonable hour for the <br /> purposes of inspection or other enforcement action. DocuSigned by: <br /> 2FDC298C819F48B... <br /> Owner Signature(s) Applicant Signature (if different from owner) <br /> 4/24/2024 <br /> Date Date <br /> Section Completed by Staff <br /> Zoning: Watershed: <br /> Other overlay districts impacting property: <br /> Stream on lot?❑Yes❑ No <br /> Floodplain on lot? Yes MNo <br /> Note: If the property to be subdivided is currently under farm use value taxation, please contact the <br /> Orange County Tax Office at 919-245-2100. Subdivision of the property may require payment of <br /> deferred taxes under farm use value taxation. <br /> Page 2 of 2 <br />