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• <br /> Y <br /> . <br /> ,40(0,-----„,„„ <br /> o _ ',, Dane County Planning & Development <br /> 1 �I i Zoning Division <br /> �'��� ,t'j La�j �`s <br /> hh``s � <br /> Substantial Farm Income Review Application <br /> Applicant Name 77/)(9.---01. 4---14G a/ 5L& <br /> Address I 05-5-9 5 G-\./ 131iii-C V'vox-Iylds Yc/ <br /> 1-31Gt t )'10 - 5 "5-3s/ 7 <br /> Phone D� - L/3-2 - C6936 <br /> Is the applicant the current owner of this property? / N <br /> If NO, who is the current owner of this property? <br /> PROPERTY LOCATION <br /> • Township(s) Section(s) 1/4- 1/4(s) Parcel Number(s) <br /> Total acres in farm: )� <br /> Signature of Applicant(s) ✓ t, .Jjt Date -J —1 1 � —0 c( <br /> STATUS CHECKLIST(OFFICE,USE ONLY): _ ,= <br /> Paid Application Fee ($f:65)-- Receipt# ,.,...««..c (date) <br /> Form Conservation Plan Approval w , ° • 4,4 ,tdate) i <br /> Submitted signed "`Document of Understar din `' i.., derfe <br /> Submitted Schedule "F" and owners°certificatio da€ej <br /> Plannin Division a roval consistent with Town:Land Use Plan .... . <br /> 9 PP, <br /> d <br /> 'Obtained Township(s).approval., ,.. (date) <br /> Zoning Administrator Review Completed: APPROVED / DENIED • <br /> Signature of Zoning Administrator Date <br /> 210 Martin Luther lung Jr.Blvd.• Room 116,City-County Bldg.• Madison,WI 53703-3342•:•Phone:608.266.4266 Fax:608.267.1540 <br /> \vww.Gountyofdanc.com/zoning <br /> 1-I:\Zoning\Farm Substantial Income Review\NEW Farm plan application(10-08).doc <br />