N.C. Department of Agriculture & Consumer Services
N.C. ADFP Trust Fund
Grantee Monitoring Checklist – Perpetual or Term Easement
Grantee Information:
ADFP Tracking Number: ADM-ADFP-10-031
Grantee: Orange County
Project Title: Breeze Farm Easement
Grant Cycle: Cycle III
Current Grant Status: Closed
County of Easement: Orange
Acreage Under Easement: 153.51 acres
Deed book and page number: Bk. 5314 Pg. 11
Date of Last Report:
Tax ID Number: 56- 6000327
Date of Contract: 7/1/2010 -3/30/2012
Staff Assigned: John Ray Davis
Perpetual Easement
Is property mapped in GIS? Yes
Date of recordation: 2/16/2012
To be completed by the grantee:
Date of Report:
Grantee Contact:
Grantee Mailing Address:
Grantee E-mail:
Landowner’s name(s):
Easement Address:
Grantee Phone:
Grantee City & Zip:
Grantee Fax:
Landowner(s) Phone:
Easement City & Zip:
Please select the following activities and uses on the easement since the last report.
Agricultural Uses
Agricultural (includes pastures)
If not in production, please explain:
Horticultural
Forestry
Conservation Practices
Is the landowner using agricultural best management practices?
Is the landowner following a current conservation plan?
Is the landowner following a current forestry management plan?
Creation date of current conservation plan:
N/A
Creation date of current forestry management plan:
N/A
Please explain any “No” answer:
Forestry Management
Has timber harvesting occurred?
Has prescribed burning occurred?
Has the planting of trees occurred?
Has the thinning of a stand of trees occurred?
Notes:
Topographical Changes and Uses
Have any new buildings, dwellings, or barns been constructed?
Has there been creation or expansion of agricultural fields or pastures?
Is there evidence of sand/gravel/soil/rock, etc. being removed?
Not in production
Yes
Yes
Yes
No
No
No
N/A
N/A
Yes
Yes
Yes
Yes
No
No
No
No
N/A
N/A
N/A
N/A
Yes
Yes
Yes
No
No
No
Have new roads been constructed?
Has there been repair on existing roads?
Has there been construction of utility lines or right-of-way corridors?
Have any new fences been constructed?
Have any surfaces been converted to an impervious surface?
Have any erosion control structures been installed on roads?
Is there evidence of trash accumulation, dumping, or organic debris?
Have any new trails been constructed?
Has there been repair on existing trails?
Is there evidence of abusive ATV or recreational vehicle activity?
Has there been any alternations of streams, rivers, or creeks?
Have any stream crossings been installed?
Has there been any alterations of riparian vegetation?
Is there notable soil erosion?
Is there evidence of trespassing or encroachment on the easement?
Please explain any “Yes” answer:
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Is the landowner in compliance with the terms and conditions of the conservation easement?
Yes
No
Grantee should attach any photos or supplemental documentation to provide the ADFP Trust Fund with
updated project information.
I confirm that the information listed above is accurate and in compliance with the terms and
conditions of my contract held with the N.C. Department of Agriculture and Consumer Services.
_______________________________________________________
Grantee’s Signature
_________________________________
Date
For ADFP Office Staff Use Only:
Received and reviewed by ADFP Office Staff:
______________________________________ _______________________
Signature
Date