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• Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> (1) Name of Owner(s) Kalscheur Kip + Kitt <br /> (2) Mailing Address (Last) (First) (Middle Initial) <br /> of Owner 3828 Garfoot Road, Mt. Horeb, WI ZIP Code 53572 (3)Phone 798-2628 <br /> (4) Location of the land Cross Plains Sec. 20 7N 7E Dane <br /> Town,Village,or City Section,Township, Range County <br /> (If part of the owner's farmland is located in another town,village, or city,please submit information about that farmland on a separate form.) <br /> EXCLUSIVE AGRICULTURAL ZONING <br /> (5) Dane has an exclusive agricultural zoning ordinance which has been certified <br /> (County, Town,Village or City) <br /> by the State Land Conservation Board on (date) 5/18/78 <br /> (6) FC— below the type of ordinance jurisdiction which applies and give the date of local approval (effective date of ordinance). <br /> IX Town under county exclusive agricultural zoning. Local approval date December 26, 1981 <br /> n Town with separate town ordinance. Local approval date <br /> ❑ City or village: Check one or both below. <br /> n Within corporate limits. Local approval date <br /> n Extraterritorial. Local approval date <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? <br /> Yes No Li <br /> Land on which tax credit is claimed: <br /> ____j8l2prcellloJfrom tax rollsL (91 Total Acres in Parcel —__w— (101 Acres in Exclusive Ag. District <br /> 0707-204-8500-5 40.9000 40.9000 wMw_ <br /> 0707-202-9500-5 41. 1000 41.1000 <br /> 0707-203-8000-1 40.9000 40.9000 <br /> 0707-203-8500-6 4 0. 7000 40.7000 <br /> 0707-201-9000-1 4 0. 8000 40.8000 <br /> 0707-202-9000-0 34. 6000 34.6000 <br /> Total _ 239.0 Total 239.0 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) Dane County has adopted an agricultural preservation plan which was certified <br /> on (date) 12/4/81 by the State Land Conservation Board. <br /> SOIL AND WATER CONSERVATION POLICY <br /> Dane <br /> (12) <br /> County Land Conservation Committee has adopted a soil and water conservation <br /> policy which was approved on (date) April 8, 1986 by the State Land Conservation Board. No notice of <br /> noncompliance is in effect for lands hereby certified. <br /> CERTIFICATION <br /> Signature of Zoning Authority Program Year <br /> Title ZONING ADMINISTRATOR Date <br /> RE-CERTIFICATION <br /> (Note:If any of the above information has changed,please submit a new zoning certificate.) <br /> The undersigned hereby certifies that the information contained on this form is true and correct on the most recent date shown below. <br /> 1. <br /> Signature of Zoning Authority Title Date Program Year <br /> 2. <br /> Signature of Zoning Authority Title Date Program Year <br /> 3. <br /> Signature of Zoning Authority Title Date Program Yeas. <br /> 4. <br /> Signature of Zoning Authority Title Date Program Year <br /> (The land must be in an exclusive 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 credit claim is filed with the Wisconsin Department of Revenue.) <br /> ARM-LR-2(Rev 11/86) <br />