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Attach to Wisconsin Income Tax Schedule FC ZONING CERTIFICATE - FARMLAND PRESERVATION ACT - STATE OF WISCONSIN (1) Name of Owners(s) YELK DAVID & LORI (Last) (First) (Middle Initial) (2) Address R#2, CROSS PLAINS, WI 53528 (3) Phone 608-000-0000 (4) Location of the land TOWN OF BERRY 27 08T 07R DANE Town, Village, or City ction, Township, Range County (If part of the owner's farmland is located in another town,village,or city,sehmit information about that farmland on a separate form) EXCLUSIVE AGRICULTURAL ZONING (5) DANE COUNTY has an exclusive agricultural zonino erdin-nce which has been certified (County,Town,Village or City) by the State Agricultural Lands Pr,=--rvati,-n Board. On (date) 12/04/81, (6) Check below the type of ordinance jurisdistion which applies and give the d-te of local approval(effective date of ordinance). Town under county county exclusive agricultural zoning. Local - 'ote Town with separate town ordinance. Local approval date 12/12/8,1 (7) Does each structure or improvement on the land conform to the require„-n tc of the exclusive agricultural zoning ordinance ? Yes X NO Land on which tax credit is claimed (8) Parcel No.(from tax rolls) (9) Total acres in Parcel (10) =s in Fx. Ag. District (11) Are improvements in Ex. Ag. Zoning District 0807-272-9500-9 40.2000 P 0 0807-272-8000-6 40.3000 0807-271-9000-5 39.5000 1 0807-271-8530-6 30.5800 ) TOTAL 150.5800 TOTAL 5 1 a===ads=saa===a=s ==a=======a========== ===a===s== AGRICULTURAL PRESERVATION PLAN AND SOIL 'ER CONSERVATION STANDARDS (1 2) DANE County has adopted an agricultural preservation - was certified on(date) 12/4/81 by the State Agricultural Lands Preservation Board. DANE County soil and water conservation policy which was approved by the State Land Conservation Board on(date) 4/8/86. No notice 'ance is in effect for lands hereby certified. - -- - CERTIFICATIC - (NOTE: IF ANY OF THE ABOVE INFORMATION HAS CHANGED P' 'T A NEW ZONING CERTIFICATE.) The undersigned Zoning Authority hereby certifies that th - formation contained on this form is true and correct on the most recent date shown below. The undersi,c d r 'nervation Committee (LCC) Authority hereby certifies the above landowners notification of intent t- --laim under subch. IX, ch. 71, Wis. Stets. 02/06/98 02/06/98 1992 Signature of Zoning Authority Date Signature of LCC Date Program Year (The land most be in a certified agricultural zone on Dec. 31 of the year - ,dit is being claimed. This certificate, along with property tax bills, must be included with the Schedule FC when a fair' — -tion credit claim is filed with the Wisconsin Department of Revenue). ARM-LR-2 (Rev 9/92)