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Attach to Wisconsin Income Tar Schedule FC <br /> ZONING CERTIFICATE - FARMLAND PRESERVATION ACT - STATE OF WISCONSIN <br /> (1) Name of Ownora(a) LEE ERVIN D. 6 SHARON <br /> (Last) (First) (Middle Initial) <br /> (2) Address 9421 UNION VALLEY RD., BLACK EARTH. WI 53515 (3) Phone 608-767-3637 <br /> (4) Location of the land TOWN OF VERMONT 12 11 07T 06R DANE <br /> Town, Village, or City Section, Township, Range County <br /> (If part of the owner's farmland is located in another torn,village,or city,submit inforamtion about that farmland on a separate form) <br /> axaaaxxaa sass sss sssssssssssssssaassasssassasaaas <br /> ssaa aaaaaaaasasszsaaxaa <br /> EXCLUSIVE AGRICULTURAL ZONING <br /> (5) DANE COUNTY has an exclusive agricultural zoning ordinance which has been certified <br /> (County,Town,Village or City) by the State Agricultural Lands Preservation Board. On (date) 12/04/81 <br /> (6) Check below the type of ordinance jurisdistion which applies and give the date of local apprawl(effective date of ordinance). <br /> Torn under county county exclusive agricultural zoning. Local approval date <br /> Town with separate town ordinance. Local approval date 10/12/79 <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance 7 <br /> Yes X NO <br /> Land on which tax credit is claimed <br /> (8) Parcel No.(from tax rolls) (9) Total acres in Parcel (10) Acres in Ex. Ag. District (11) Are improvements in Ex. <br /> Ag. Zoning District <br /> 0706-124-8070-5 5.0Q00 5.0000 <br /> 0706-121-9500-5 40.0000 40.0000 <br /> 0706-121-8000-2 40.0000 40.0000 MO_____ <br /> 0706-111-8390-3 .2000 .2000 <br /> 0706-121-8500-7 40.0000 37.0000 MQ____ <br /> 0706-122-8000-1 40.0000 40.0000 N_ <br /> 0706-122-8500-6 40.0000 40.0000 N_ <br /> 0706-122-9510-2 18.0000 18.0000 NO <br /> TOTAL 223.2000 TOTAL 220.2000 <br /> x------sasaaaaaaaaaassssssssss eases:sss sss sss ssssssssasssssssasaassassssssss asssssasssassssssassssssa <br /> AGRICULTURAL PRESERVATION PLAN AND SOIL AND WATER CONSERVATION STANDARDS <br /> (12) DANE County has adopted an agricultural preservation plan which was certified on(date) 12/4/81 by the <br /> State Agricultural Lands Preservation Board. DANE County has adopted a soil and water conservation policy which was <br /> approved by the State Land Conservation Board on(date) 4/8/86. No notice of noncompliance is in effect for lands hereby certified. <br /> =____== ssa :sass:asssaassass ass:assssss::sssssassssasssaasss ssa <br /> CERTIFICATION <br /> (NOTE: IF ANY OF THE ABOVE INFORMATION HAS CHANGED PLEASE SUBMIT A NEW ZONING CERTIFICATE.) <br /> The undersigned Zoning Authority hereby certifies that the zoning information contained on this form is <br /> true and correct on the most recant date shown below. The undersigned Land Conservation Committee (LCC) Authority <br /> hereby certifies the above landowner's notification of intent to submit a claim under subch. IX, ch. 71, Wis. Stets. <br /> 07/03/98 07/03/98 1997 <br /> Signature of Zoning Authority Date Signature of LCC Authority Date Program Year <br /> (The land must be in a certified agricultural zone on Dec. 31 of the year for which credit is being claimed. This certificate, along <br /> with property tax bills, must be included with the Schedule FC when a farmland preservation credit claim is filed <br /> with the Wisconsin Department of Revenue). <br /> ARM-LR-2 (Rev 9/92) <br />