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Attach to Wisconsin Income Tax Schedule FC\i,\p CE IFICA E - FARMLAND PRESERVATION ACT - STATE OF WISCONSIN <br /> Dane County Planning & Development <br /> (1) T_'* ers(s) RALTEN B RG JOSEPH W. & KAREN M. <br /> ��L,,I Roofs I��� G1I - ,ouni Building, Madison, WIS /09 <br /> ,, am , .� (�g�t� G Y �F �t� (Midd14-4}i'tiQkg1ipn Review <br /> (2) ��\,-=__ 5989 CTH TT, COTTAGE GROVE, WI 53527 (3) Ph G6b0P837-8044 <br /> Property Listing <br /> (4) Location of the land TOWN OF SUN PRAIRIE 34 27 08T 118/266-4E <br /> Town, Village, or City Section, Township, Range SUIVeY@tiunty <br /> (If part of the owner's farmland is located in another town,village,or city,submit information about that farmlaWW Piiparate form) <br /> 4 <br /> 608/266-4266 <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 01/01/01 <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 /> 081 13.6710 13.6710 NO <br /> •: •u'' 1— 34.3000 34.3000 NO <br /> D811-341-8500-: 39.2000 39.2000 YES <br /> 0811-274-9000-3 40.0000 40.0000 NO <br /> 0811-273-9500-9 40.0000 40.0000 NO <br /> 0811-342-8460-6 .9180 .9180 NO <br /> TOTAL 168.0890 TOTAL 168.0890 <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 /> 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. Stets. <br /> 05/05/97 05/05/97 1996 <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 />