COUNTY___________________________________
TOWNSHIP_________________________________
APPLICANT LAST NAME____________________
APPLICANT FIRST NAME____________________
Farmland Preservation Program
Application For An Easement Purchase
Cost Share Grant
2007(A) Funding Round
For SADC use only
SADC ID#______________________________
Date Received___________________________
Staff Reviewer__________________________
State Agriculture Development Committee
Application For An Easement Purchase Cost Share Grant
Farmland Preservation Program
2007(A) Funding Round
Checklist of Enclosed Items
(ALL checklist items are REQUIRED for administrative completeness of
this application; Omissions may delay review and ranking of this application.)
PLEASE READ AND FOLLOW THE REVISED GENERAL DIRECTIONS FOR
COMPLETING THE 2007A COUNTY COST SHARE GRANT APPLICATION CAREFULLY
AND BE SURE TO PROVIDE ALL DOCUMENTATION AS REQUIRED ON THE CHECKLIST!
COMPLETE Applications must be SUBMITTED BY THE SEPTEMBER 15, 2005 DEADLINE!
(CADB ADMINISTRATORS) PLEASE CHECK OFF THE FOLLOWING UPON COMPLETION:
 Completed Application
 Current RECORDED DEED of Ownership.
 CONTRACT PURCHASER AGREEMENT, if appropriate.
 Current recorded DEED OF EASEMENT, if appropriate.
 TAX MAP with lot boundaries, exceptions, existing residences, and adjacent land uses
clearly identified.
 Current FARM TAX ASSESSMENT FORM with Land Use (crops/products) identified.
 GIS MAP or 7.5 minute USGS TOPOGRAPHIC QUAD MAP with the application lot
boundaries and any preserved farms (current applications or previously preserved) within
one-half mile of the application parcel(s) clearly identified.
 USDA NRCS or GIS SOILS MAP with lot boundaries and exceptions clearly identified;
 SOIL CALCULATIONS including soil map units, acres and percentages of each unit.
 Copy of Municipal Right to Farm Ordinance, if appropriate.
 OPEN SPACE and/or FARMLAND PRESERVATION ELEMENT from Municipal
Master Plan, if appropriate (only one copy per municipality is needed.)
 Signed affidavit of County Agriculture Development Board Verification.
~ Thank you for your time and participation
Helping to preserve Agriculture in New Jersey.
A
CADB ADMINISTRATIVE VERIFICATION:
** TO AVOID AMENDING APPLICATIONS SUBSEQUENT TO SADC APPROVAL,
WHICH CAN DELAY THE RANKING PROCESS, the CADB should verify that:
 The application is accurate, complete and final; Required documentation has been provided.
 Application copy has been sent to each independent appraiser.
 Required onsite inspection of premises has been completed.
The following have been thoroughly explained to the applicant:
 Restrictions including severable and non-severable exceptions.
 Any changes to application may result in withdrawal from current round.
 A negative point will be assessed for exceptions exceeding 10% of the Premises.
Prepared by:________________________________________________________
CADB staff
GENERAL INFORMATION:
Date:
_____________________________
County:
_____________________________
Municipality:
_____________________________
Applicant(s):
_____________________________
Land Owner/s of Record (as per recorded deed):
_____________________________
Street Address/description of the farm location:
_____________________________
USGS Grid Map Number and name:
_____________________________
(Please provide USGS Quad number)
Is the farm currently enrolled in an 8-year program?
YES
NO
Municipally Approved Farmland Preservation Program?
YES
NO
Farmland Preservation Program?
YES
NO
Date of Enrollment:
_________
B
LOCAL ZONING:
Identify the current zoning and zoning as of January 1, 2004 for appraisal purposes. The subject
property is to be appraised under both zonings in accordance with the Highlands Water Protection
and Planning Act [(Section 54) Amends Section 38 of P.L.1999 c.152 (c.13:8C-38)].
Current Zoning ______________________ Minimum area requirement: _____________________
Jan. 1, 2004 Zoning __________________ Minimum area requirement: _____________________
 Has the subject property been owned
continuously by the same individual or entity
since August 10, 2004?
 Is the current owner of the subject property an
immediate family member of the person who
owned the subject property on August 10, 2004?
 If the answer to both of the above questions is
“NO”, can the current owner or operator of the
farming operation be considered a “farmer” as
defined by the SADC? (i.e., during calendar year
2004, did the owner or operator realize gross
sales of at least $2,500.00 of agricultural or
horticultural products produced on the farming
operation, exclusive of any income received for
rental of lands?)
YES
NO
YES
NO
YES
NO
YES
NO
o If “YES”, please provide copies of
documentation
from
the
applicant,
including sales receipts and/or federal tax
forms.
 Does the current owner waive the use of the
zoning as of January 1, 2004 for appraisal
purposes? If so, please provide proof of such
waiver.
C
APPLICANT INFORMATION
Page ___ of ___
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE ALL APPLICATION PARTICIPANTS.
Please enter for each related party applying for easement purchase (landowner of record, contract purchaser, current
owner of the easement); If the applicant is an estate represented by an executor, please list the executor as the primary
applicant contact if there is more than one applicant/owner. If the applicant is represented by an attorney or other legal
representation, please provide that individual’s contact information in the appropriate space provided below.
Name (Primary Contact): ______________________________________________________
Address:
_______________________________________________________________
City:
_________________________ State: ____________ Zip Code: ________
Phone (bus.): __________________________________ Fax: _______________________
Phone (home): __________________________________
Type of Application Participation: (check one)
(
(
(
(
(
(
)
)
)
)
)
)
Sole Proprietor (Husband/Wife)
Partner of a Partnership
Proprietor or Multi-Proprietor
Executor of an Estate
Corporate Officer in a Corporation
Trustee of a Trust
(
(
(
(
(
(
)
)
)
)
)
)
Contract Purchaser (Fee Simple)
Contract Purchaser (Easement)
Municipality (current easement owner)
County (current easement owner)
Conservation Organization
Institution
Name:
_______________________________________________________________
Address:
_______________________________________________________________
City:
_________________________ State: ____________ Zip Code: ________
Phone (bus.): __________________________________ Fax: _______________________
Phone (home): __________________________________
Type of Participation: (check one)
(
(
(
(
(
(
)
)
)
)
)
)
Sole Proprietor (Husband/Wife)
Partner of a Partnership
Proprietor or Multi-Proprietor
Executor of an Estate
Corporate Officer in a Corporation
Trustee of a Trust
(
(
(
(
(
(
)
)
)
)
)
)
Contract Purchaser (Fee Simple)
Contract Purchaser (Easement)
Municipality (current easement owner)
County (current easement owner)
Conservation Organization
Institution
Primary Contact if not applicant/owner__________________________________________________
Address: ______________________________________________________________________
City:
_______________________________ State: ____________ Zip Code: _________
Phone (bus.): ____________________________ Fax: _____________________________
Phone (home): ___________________________
( ) Lawyer or Legal Representative
( ) Realtor of a Real-estate Agency
D
( ) Other
BLOCK, LOT & ACREAGE
Page ___ of ___
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE EACH LOT and/or EXCEPTION
SEPARATELY. (One and Only One Lot and/or Exception per Page.)
County / Municipal Code: ______ Block: _______ Lot: _________ Acres: ______
NJ State Development and Redevelopment Code: (check one)
(exact tax map acres)
(
(
(
(
)
)
)
)
(PA1) Metropolitan
(PA2) Suburban
(PA3) Fringe
(P10) Pinelands
EXCEPTION
(
(
(
(
)
)
)
)
(PA4) Rural
(PA4b) Rural & Environmentally Sensitive
(PA5) Environmentally Sensitive
Other
.
(Specific to above Lot ONLY)
EXCEPTIONS ARE AREAS THE OWNER DOES NOT WISH TO HAVE ENCUMBERED BY THE FARMLAND PRESERVATION DEED
RESTRICTIONS. SEVERABLE EXCEPTIONS MAY BE SUBDIVIDED AND SOLD SEPARATELY FROM THE FARM. NONSEVERABLE EXCEPTIONS MAY NOT BE SUBDIVIDED FROM THE FARM.
1. Acreage of exception:
________________________________________
2. Site Specific Local Zoning including
minimum lot size requirements:
________________________________________
3. Applicant’s reason for exception:
(Describe any non-residential activities)
________________________________________
________________________________________
4. Justification provided by the CADB:
________________________________________
5. Specific Location of exception as depicted
on attached tax map:
_________________________________________
_________________________________________
6. Is the exception for county and/or municipal farmland preservation
and/or open space programs?
YES
NO
7. Can the exception be severed from the premises?
(Refer to General Directions for definition of “severable” and “non severable”)
YES
NO
8. Does the size of the individual exception exceed local zoning requirements to
construct one single family residential dwelling? If “NO”, please skip
to question #9.
YES
NO
a. How many building lots are there in excess of the local
zoning requirements for one single family residential dwelling?
_________
9. Is the landowner willing to restrict the exception to only one residential unit?
(Or EXISTING multiple units? If Yes, Please confirm number of units.)
YES
NO
10. Is Right To Farm language required on the deed of easement?
(If yes, please attach a copy of the required Right To Farm language)
YES
NO
YES
NO
YES
NO
11. Is the CADB placing other requirements on the exception?
(If the answer is YES, please attach an explanation.)
________________________________________________
12. Does the exception have a significant negative impact?
(If the answer is YES, please attach an explanation.)
E
GENERAL APPLICATION INFORMATION
Agricultural Development Area:
DESIGNATED
Highlands Preservation Area?
YES
NO
Highlands Planning Area?
YES
NO
VOLUNTARY
Watershed (First order): (check one)
( ) Upper Delaware
( ) Raritan
( ) Lower Delaware
Watershed (Second Order):
(
(
(
(
(
(
(
(
(
(
)
)
)
)
)
)
)
)
)
)
( ) Passaic
( ) Atlantic Coastal
(check one)
Upper Delaware Tributaries
Central Delaware Tributaries
Lower Passaic, Saddle
Upper Passaic, Whippany, Rockaway
North & South Branch Raritan
Millstone
Barnegat Bay
Great Egg Harbor, Tuckahoe
Maurice, Salem, Cohansey
Rancocas Creek
(
(
(
(
(
(
(
(
(
(
) Walkill, Pochuck, Papakating
) Pompton, Pequannock, Wanaque, Ramapo
) Hackensack, Pascack
) Elizabeth, Rahway, Woodbridge
) Lower Raritan, South River, Lawrence Brook
) Monmouth
) Mullica, Wading
) Cape May
) Lower Delaware Tributaries
) Crosswicks Creek
Standard Industrial Code (SIC) for Primary Farm Operation:
__________
(See Page 16 of the Instructions)
Total Gross Acres of Application Parcel(s):
__________
Total Acres of Exceptions (unrestricted areas):
__________
Net Acres of Premises to be Preserved
(Please round to nearest whole number):
__________
Number of Residual Dwelling Site Opportunities (RDSO) eligible:
__________
(Please refer to the Application Guide for eligibility criteria.)
Number of RDSOs approved by the CADB:
__________
COUNTY RANKING
How many applications were submitted to the CADB?
___________
How many applications were submitted to the SADC?
___________
What ranking, out of the total submitted to the SADC,
did the county give this application?
___________
F
RESIDENCES
Page ___ of ___
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE EACH RESIDENCE SEPARATELY.
Residential units will be restricted as recorded in the deed of easement based on the applicant’s designation and
SADC’s subsequent approval.
Please note: Exception Areas are NOT considered part of the Premises
being preserved; therefore, do NOT identify residences in exception
areas.
Are there any residences located on the Premises that is being preserved?
YES
NO
(If YES, please identify each residential structure separately below.)
RESIDENCE A (CHECK ONE ONLY)
(
(
(
(
)
)
)
)
Standard Single Family Residence
Duplex
Dormitory
Apartment
(
(
(
(
)
)
)
)
Manufactured Home with Perm. Foundation
Manufactured Home without Foundation
Single Family with apartment
Other ____________________________
Is the structure the Primary Residence?
YES
NO
Is the structure for agricultural labor housing?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
RESIDENCE B (CHECK ONE ONLY)
(
(
(
(
)
)
)
)
Standard Single Family Residence
Duplex
Dormitory
Apartment
(
(
(
(
)
)
)
)
Manufactured Home with Perm. Foundation
Manufactured Home without Foundation
Single Family with apartment
Other _____________________________
Is the structure the Primary Residence?
YES
NO
Is the structure for agricultural labor housing?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
RESIDENCE C (CHECK ONE ONLY)
(
(
(
(
)
)
)
)
Standard Single Family Residence
Duplex
Dormitory
Apartment
(
(
(
(
)
)
)
)
Manufactured Home with Perm. Foundation
Manufactured Home without Foundation
Single Family with apartment
Other ________________________________
Is the structure the Primary Residence?
YES
NO
Is the structure for agricultural labor housing?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
G
OTHER STRUCTURES (Non-Residential)
Page ____ of ____
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE EACH STRUCTURE SEPARATELY.
Please number each DUPLICATED page for this section (e.g., Page 1 of 3)
Please note: Exception Areas are NOT considered part of the Premises
being preserved; therefore, do NOT identify any non-residential
structures in exception areas.
Are there any non-residential structures located on the Premises to be preserved?
YES
NO
STRUCTURE A (CHECK ONE ONLY)
( ) Barn
( ) Garage
( ) Stable
( ) Shed
( ) Silo
( ) Other ______________________________
Is the structure for an agricultural use?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
STRUCTURE B. (CHECK ONE ONLY)
( ) Barn
( ) Garage
( ) Stable
( ) Shed
( ) Silo
( ) Other ______________________________
Is the structure for an agricultural use?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
STRUCTURE C. (CHECK ONE ONLY)
( ) Barn
( ) Garage
( ) Stable
( ) Shed
( ) Silo
( ) Other ______________________________
Is the structure for an agricultural use?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
STRUCTURE D. (CHECK ONE ONLY)
( ) Barn
( ) Garage
( ) Stable
( ) Shed
( ) Silo
( ) Other ______________________________
Is the structure for an agricultural use?
YES
NO
Is the structure under a lease or rental agreement?
YES
NO
H
EASEMENTS AND RIGHTS OF WAY
Page ___ of ___
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE EACH EASEMENT SEPARATELY.
Please number each DUPLICATED page for this section (e.g., Page 1 of 3)
Are there Easements/Rights of Way identified with the Premises
to be preserved?
YES
EASEMENT A: (CHECK ONE ONLY)
(
(
(
(
)
)
)
)
Power Lines
Water Lines
Telephone Lines
Gas Lines
(
(
(
(
)
)
)
)
Road Rights of Way
Stream Corridor
Sewer
Other __________________________
Effect of Easement:
________________________________________________
Description of Easement:
________________________________________________
EASEMENT B: (CHECK ONE ONLY)
(
(
(
(
)
)
)
)
Power Lines
Water Lines
Telephone Lines
Gas Lines
(
(
(
(
)
)
)
)
Road Rights of Way
Stream Corridor
Sewer
Other __________________________
Effect of Easement:
________________________________________________
Description of Easement:
________________________________________________
EASEMENT C: (CHECK ONE ONLY)
(
(
(
(
)
)
)
)
Power Lines
Water Lines
Telephone Lines
Gas Lines
(
(
(
(
)
)
)
)
Road Rights of Way
Stream Corridor
Sewer
Other __________________________
Effect of Easement:
________________________________________________
Description of Easement:
________________________________________________
I
NO
EXISTING NON-AGRICULTURAL USES **
Page ____ of ____
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE EACH NON-AGRICULTURAL USE
SEPARATELY
PLEASE COMPLETE EACH SECTION.


Will non-agricultural use(s) occur within the exception area(s)
on the Premises to be preserved?
YES
NO
Are there non-agricultural uses on the Premises to be preserved?
YES
NO
List the type and frequency of any existing non-agricultural uses ON THE PREMISES TO BE
PRESERVED at the time the applicant submitted to the Board: ________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Note the approximate dimensions and location of any structures and/or areas utilized for a nonagricultural use: ____________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
In the event the non-agricultural use involves a lease with another party, identify the individual or
entity leasing the structure and type of business or operation:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
If non-agricultural events are held on the premises, identify for what purpose and the frequency of
the activity:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Describe how the non-agricultural use will be accessed on the premises.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
**NOTE:
Appraisers must be aware of non-agricultural uses and determine their impact on the
development easement value in their reports pursuant to the SADC Appraiser’s Handbook.
If you have any questions regarding potential non-agricultural use, please address them
with the SADC prior to submission of the application.
An identified non-agricultural use can NOT be expanded or intensified after the premises is
preserved.
J
LOCAL COMMITMENT
Page ___ of ___
Please number each DUPLICATED page for THIS SECTION. (e.g., Page 1 of 3)
Duplicate this sheet as necessary to INDICATE EACH MUNICIPALITY SEPARATELY.
PLEASE COMPLETE EACH SECTION.
1. Municipality Code from Page D.
2.
_______________
a) Does local zoning require an average minimum lot size of at least three acres
with clustering and/or mandatory buffering to provide separation
between development and existing agricultural operations?
YES NO
b). Are transfer of development rights/credits available?
YES
NO
c)
YES
NO
YES
NO
Is a sliding scale utilized?
d) Is the zoning for very low density? If Yes, provide justification.
e) Are there other equivalent measures?
YES NO
Explain _____________________________________________________
3. Is there sewer or other growth leading infrastructure already serving
or immediately adjacent to the premises?
YES
NO
4. Is purchase of development easements consistent with State
Development and Redevelopment Plan and county and local plans?
YES
NO
5. Is there an active municipal liaison with the CADB?
YES NO
Please provide name and phone number____________________________________
6. Do planning board actions regarding nonagricultural development
support farmland preservation? (i.e.: as supported by the Master Plan?) YES
NO
7. Do municipal governing body actions regarding nonagricultural
development support farmland preservation?
YES
NO
8. Has the municipality ever passed an ordinance approving a municipally
approved 8 year program (MAFPP)?
YES
NO
9. Have development easements already been purchased in the municipality?
YES
NO
10. Does the municipality have a “Right To Farm” ordinance?
Please provide a copy of the municipal ordinance.
YES
NO
YES
NO
11. Does the municipality’s “Right To Farm” ordinance require a developer
and/or landowner, who plans to build or sell a dwelling in an agricultural
area, to inform prospective purchasers through their agent, of the existence
of the “Right To Farm” ordinance and the protection it grants to agricultural
operations? This notification is included in the deed of record.
K
Municipality’s CUMULATIVE COMMITTED FUNDS FOR FARMLAND PRESERVATION
since 1980*:
Budget
________________________
Referendum
________________________
Trust Funds
________________________
Bonds
________________________
Other
________________________
Total Funds
________________________
*
This does NOT include a county tax for Open Space.
L
IMMINENCE OF CHANGE OR CONVERSION
Please attach adequate documentation to support responses to this section.
Is the record owner of the Premises involved in an estate situation?
Has the record owner filed for:
BANKRUPTCY
YES
FORECLOSURE
NO
N/A
(Please circle appropriate answer.)
SUBDIVISION REQUEST**
Subdivision for non-agricultural development of the premises must be identified. If a subdivision
exists by final resolution at the date of the appraisal, the appraiser shall not consider its impact in
the restricted condition. Otherwise, an application with a severable exception shall be considered as
to its intended purpose in the “after value” appraisal analysis.
**Copies of the municipal and county approvals/resolutions are required for consideration.
Type of development being considered for subdivision: (Check One)
( ) Residential
( ) Industrial
( ) Commercial
( ) Public Use
( ) Farm Subdivision
Preliminary Approval Date.
__________
Final Approval Date.
__________
Scale of Subdivision
MAJOR
MINOR
Enter any other pertinent information to help fully describe the request.
Please indicate subdivision on attached Tax Map.
_______________________________________________________________________
_______________________________________________________________________
M
SOILS
(Soil calculations provided by the CADB will be verified by SADC. Counties with SSURGO will be
verified utilizing SSURGO; all others will be verified using the NJDEP version of USDA-NRCS soil
surveys. Once a county has its SSURGO files certified by NRCS, this federally approved data should
supercede the NJDEP data files.)
**EXCEPTION ACRES SHOULD NOT BE USED TO CALCULATE SOIL SCORE.
Indicate the percentage of the following types of classification of important farmlands as shown on
attached calculations of acres/soil unit.)
Prime
_______acres =
________%
Statewide
_______acres =
________%
Local
_______acres =
________%
_______acres =
________%
Unique (of value)
_______________
List crop(s) grown on unique soil.
___________________
Please identify unique soils.
___________________
Other (of no value) _______________
_______acres
_________%
TOTAL NET ACRES
________acres
=
100 %
TILLABLE ACRES
(Verified by current Farm Tax Assessment Form and aerial photography interpretation)
Indicate the percentage of the premises that is classified under the following categories.
Cropland Harvested
_______acres =
________%
Cropland Pastured
_______acres =
________%
Permanent Pasture
_______acres =
________%
Woodlands
_______acres =
________%
Wetlands
_______acres =
________%
Other _______________________
_______acres =
________%
TOTAL NET ACRES
________acres
=
N
100 %
BOUNDARIES AND BUFFERS (as depicted on attached GIS or USGS Topo map)
Indicate the percentage of the following Buffers and Boundaries to the subject property.
(Please refer to the Application Guide for directions in calculating percents of boundaries.)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
17.
Deed Restricted Farmland (permanent)
Deed Restricted Wildlife Areas
Stream (perennial) and Wetlands
Cemeteries
Parks (limited public access)
Military Installations
Golf Course (public)
8 Year Programs and EP Applications
Highways (limited access) and Railroads
Farmland (unrestricted)
Woodlands
Parks (high use)
Residential Development (with infrastructure)
Residential (less than 5 acres w/o infrastructure)
Commercial
Industrial
Schools
Other ________________________________
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
________%
100 %
DENSITY OR CONTIGUOUS PROPERTIES
List, by name and round (e.g. 2004A EP), lands that are reasonably contiguous (within ½ mile
linear distance) to the subject application which are comprised of: development easement purchase
applications approved by the CADB and received by the SADC during the current round,
applications with final approval, lands where development easements have already been
purchased, and other permanently deed restricted active farmlands. Include subject application if
not an isolated parcel.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
List, by name, lands that are reasonably contiguous (within ½ mile linear distance) to the subject
application and currently enrolled in an 8 Year Farmland Preservation Program.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
O
Affidavit of County Agriculture Development Board
Verification
County of
State of NEW JERSEY
}
} SS
__________________________
Name of Affiant
Being duly sworn according to law, upon his/her oath, disposes and says:
1. I am the Chairperson of the _______________________County Agriculture Development
Board (hereinafter “Board”) and am fully aware of all the actions the Board has taken.
2. At its meeting on _________________________, 200_____ the Board pursuant to NJAC
2:76-6.5, granted preliminary approval to the application of _______________________ to
sell a development easement on their farm as described in the attached Board application for
an easement purchase cost share grant.
3. Staff of the Board has performed a site inspection of this property on
____________________.
4. The two SADC certified appraisers hired to evaluate the development easement on this
property have received a copy of the landowner’s application.
5. All information contained in the attached application for an easement purchase cost share
grant is complete and accurate.
____________________________
Chairperson, ______________ CADB
Sworn and Subscribed before me
this _____ day of _________________, 200___.
_______________________________
Notary Public
P
ADDENDUM A:
(PROVIDE ADDITIONAL INFORMATION AS NEEDED REGARDING EXCEPTIONS,
RESIDENCES, STRUCTURES, NON AGRICULTURAL USES, ADDITIONAL RESTRICTIONS,
ETC.)
Date:
_____________________________
County:
_____________________________
Municipality:
_____________________________
Applicant(s):
_____________________________
Land Owner/s of Record (as per recorded deed):
_____________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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