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VOLUNTARY AGRICULTURAL DISTRICT <br />INSTRUCTIONS: Before completing the application, please review the provisions oC the Orange <br />County Voluntary Farmland Preservation Program Ordinance, then fill out the <br />form as accurately and completely as possible, Please sign and date the form, and <br />return it to the Orange County Environment and Resource Conservation <br />Department, BOLA Revere Road, Hillsborough, NC 27278 <br />APPLICANT: <br />Name: VicCor Cazl Walters 7r & Elizabeth T. Walters <br />Address: 7119 Hieh Rock Road <br />City: Efland State: NC 7_ip Code: 27243 <br />Phone Number (Day): 563-3842 (Evening) <br />PROPERTY INFORMATION: <br />Property L.ocatiorr/Address: N/O 1340 <br />Township: Cedar Grove Tax Map: 42 Block: 42 L.ot: I lA <br />Parcel Identification Number (PI2~: 9836-09-3000 <br />Number of Acres: I 11.335 Deed Book: 220 Page: 195 <br />Does this land have a plan on file with the Natural Resources Conservation Service or NC Forest <br />Service? <br />Yes: X No: If "No", please complete back of form <br />Is this land listed for Present Use 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], hereby certify ttrat, to the best of my [our] knowledge, the foregoing <br />application is complete and accurate. <br />~ ~'OJr <br />._ O <br />Please direct inquiries to: <br />do Orange Connty Lm~irmm+eu! m+d Respurce Co+rserva(ion Deparbnen! <br />306A Revere Road <br />Hillsborm+gb, NC 27278 <br />Hillsborough • 932-8]81 Cbnpc/ Hill • 967-9251 Durban • 688-7.3.37 Alebrsne •?27-2031 <br />