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Attach to Wisconsin Income Tax Schedule FC <br /> fIG CE D P ACST E OF WISCONSIN <br /> s ��1; ane�ounty�1'anning�"�evelopmen� <br /> (1 y� -1 ( ) I-itnn I 1 , -1 ,i gty Bu ifdir g, tot disCn, Wi (First) ( Laud �i�siol l Review <br /> �Nq�114�immiot#- (Last) First Middle n 6`619086 <br /> (2) , ,. = 765 TOWER DR., STOUGHTON, WI 53589 (3) ryrtgt fi_ 6LQ8-873-6410 <br /> 608/266-4120 <br /> (4) Location of the land TOWN OF DUNKIRK 24 23 05T 11Rulvey�DAN.E <br /> Town, Village, or City Section, Township, Range 608/266-4259unty <br /> (If part of the owner's farmland is located in another town,village,or city,submit information about that farmland on separate form) <br /> coning <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 approval(effective date of ordinance). <br /> Town under county county exclusive agricultural zoning. Local approval date <br /> Town with separate town ordinance. Local approval date 12/17/79 <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance ? <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 /> 0511-241-8700-3 14.9500 14.9500 NO <br /> 0511-242-8200-7 19.9500 19.9500 NO <br /> 0511-231-9500-5 39.9000 39.9000 NO <br /> 0511-231-8000-2 39.9000 39.7700 YES <br /> ,1 rj <br /> TOTAL 114.7000 TOTAL 114.5700 <br /> AGRICULTURAL PRESERVATION PLAN AND SOIL AND WATER CONSERVATION STANDARDS <br /> (1 2) 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 /> 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 recent 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. Stats. <br /> 08/13/97 _ 08/13/97 1996 <br /> Signature of Zoning Authority Date Signature of LCC Authority Date Program Year <br /> ( he land must be in a certified agricultural zone on Dec. 31 of the year for which credit is being claimed. This certificate, along <br /> n:th 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) c� <br />