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��r��"�,, Attach to Wisconsin Income Tax Schedule FC <br /> s p4 �►�io`�,, CE IFICA - FARMLAND PRESERVATION CT - STATE OF WISCONSIN <br /> I �': y; bane Lounty`Planning & Develo IN <br /> ( ), 1. 9 pment <br /> 1 ,,�?"** ``� ers(s) KVy <br /> '1,,,,4 � �, n00111 11(1 Cuunly Builcjiiiy, MddjbUri, Ks Sn C/�g& CECELIA J. <br /> . +� �_ Last 'Yirst f (Middle} n R @VI @W <br /> (2) 'w's "Ne' 8396 COMMUNITY RD., BELLEVILLE, WI 53508 Phone Phone �08-832-4893 <br /> Property Listing <br /> (4) Location of the land TOWN OF PRIMROSE 22 23 26 05T 078/266-4DANE <br /> Town, Village, or City Section, Township, Range uryey 5�22unt <br /> (If part of the owner's farmland is Located in another town,village,or city,submit information about that farmlandd�onsa separate form) <br /> QDJ <br /> 8D8T2-68_4 2 <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 seperate town ordinance. Local approval date 12/16/85 <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 /> 0507-224-8350-7 <br /> 1.5000 1.5000 NO <br /> 0507-224-9000-8 39.2000 39.2000 <br /> 0507-224-9500-3 NO <br /> 40.6000 40.6000 NO <br /> 0507-233-8500-4 40.4000 40.4000 <br /> 0507-233-9000=i NO <br /> 39.6000 39.6000 YES <br /> ---4 0507-262=8500-9 --) 40.1000 40.1000 <br /> -,===2,-- "0507-262-9000-2 NO <br /> 40.0000 40.0000 NO <br /> TOTAL 241.4000 TOTAL 241.4000 <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 <br /> approved by the State Land Conservation Board on(date) 4/8/86. No notice of noncompliance is in effect for lands policy <br /> ereby certified. <br /> CERTIFICATION <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 /> 05/01/97 05/01/97 1996 <br /> Signature of Zoning Authority Date Signature of LCC Authority Date Progra 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) 0 <br />