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NCDA &CS ADFP Trust Fund <br />Grant Cycle Vl Easement Application <br />For Agricultural, Horticultural, & Forestry Programs <br />Please direct all questions and concerns to: <br />NCDA &CS ADFP Trust Fund <br />2 W. Edenton Street <br />Raleigh, NC 27601 <br />919.733.3071 <br />Fax: 919.716.0105 <br />Departmental Use Only <br />Date Received: <br />Application #: <br />Requested Amount: $ <br />Project Value: $ <br />n dfp nca ,qr.q a v i w ww,,ncadfip ora <br />All information in this application is required, Incomplete applications will be considered ineligible <br />for funding. Application must be delivered to the AM=P Trust Fund office no later than 5:00 PM on <br />December 17, 2012. <br />Project Title: Michael Barrier Permanent Conservation Easement ( Cabarrus) <br />(5 words or less, must denote County and ownership) <br />County l Counties of Project Location: Cabarrus <br />Funds Requested of ADFP: $44,400.00 Matching Funds At Time of Application: $ 155451,00 <br />Size of Easement: 35.52 acres Estimated Easement Value: $177,600,00 <br />(Permanent) or Term (circle appropriate) If term, designate number of years: <br />APPLICANT IDENTIFICATION INFORMATION <br />Name of Applicant: <br />(Must be a county or non - proof conservation organization) <br />Applicant Tax Identification Number <br />Cabarrus Soil and Water Conservation District <br />56- 6000281 <br />DUNS Number <br />Applicant Website Address (if applicable) <br />965929263 <br />www.cabarruscounty,us /conservation <br />Person responsible for working with the project Dennis Testerman <br />Telephone numbers: Office: 704 - 920 -3303 <br />Mobile: 980 - 521 -4871 <br />Fax: 704 - 7956432 <br />Alternate Contact Person <br />Telephone numbers: Office: <br />Mobile: <br />Fax: <br />Applicant Mailing Address: <br />(if delivered by U5 Postal Service) <br />Street: 715 Cabarrus Avenue West <br />City: Concord <br />State: North Carolina <br />Zip Cade: 28027 -6214 <br />Applicant Entail Address (if applicable): <br />Page. 2 of 20 <br />Amy Griffith <br />704 - 920 -3331 <br />704 -795 -6432 <br />Applicant Physical Address: <br />(if delivered by any other means) <br />Street: 715 Cabarrus Avenue West <br />City: Concord <br />State: 'North Carolina <br />Zip Code: 28027 -6214 <br />detesterman@cabarruscounty.us <br />Easement AppI'cation <br />A a c ment number 1 <br />F1.3M Page 370 <br />