Form Pt-48-5-7.7 - Forest Land Protection Assessment Applications Page 4
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4PT-48-5-7.7 (Aug 2011)
The following information pertains to ANY OTHER COUNTY where the tract is located and for which an application and this Covenant
may be filed.
may be filed.
Parcel Identification Number
County #1
Physical Address
Detailed description of the use of the property in the county:
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
______________________________________________________________________________________________________
We hereby adopt and ratify the Covenant for the tract of real property located in _________________ County and described herein, and
adopt the ratification of this Covenant for tracts located in any other counties.
____________________________
_________________________________________________
Date
Signature for the County Board of Assessors
Parcel Identification Number
County #2
Physical Address
Detailed description of the use of the property in the county:
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
______________________________________________________________________________________________________
We hereby adopt and ratify the Covenant for the tract of real property located in _________________ County and described herein, and
adopt the ratification of this Covenant for tracts located in any other counties.
____________________________
_________________________________________________
Date
Signature for the County Board of Assessors
NOTE: If additional space is needed for signatures and ratifications, you may attach another covenant section to this form.
Pursuant to O.C.G.A. 48-5-7.7(b)(1), if your tract is divided by a county boundary, public roadway, public easement, public right of way,
natural boundary, land lot line, or railroad track then you may, at the time of the initial application, make a one-time election to divide such
tract for the purpose of entering such tract in a Forest Land Conservation Use Covenant.
Additional Parcel Identification Numbers
Additional Parcel Identification Numbers
Page 4 of 4
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