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"`�� , Attach to Wisconsin Income Tax Schedule FC <br /> CE IFIC E — F D PRES ION ACT - STATE OF WISCONSIN <br /> ti, cane <br /> r .�, '� 15 bounty Winning �"�evelopmen� <br /> 1 0, Pliref Hers s ggpppp <br /> ( �, ( ) f�l.Cl,Rty BU�t�.htlyrkliatfiS,N, b°ifiSC toI1�1!�Zvi�y�� Review <br /> ,,11 'Omni ' �vm (Last) (Fzrst) (Middle gn�6bviSivil R <br /> (2) '` = ;'765 TOWER DR., STOUGHTON, WI 53589 3 1h, - 7 —6410 <br /> ( ) ri upeti 6Q8.8 3 <br /> 608/266-4120 <br /> (4) Location of the land TOWN OF DUNKIRK 24 23 05T 11a p�1NE <br /> Town, Village, or City Section, Township, Range uivey unt <br /> 608/266-4 9 1' <br /> (If part of the owner's farmland is located in another town,village,or city,submit information about that farmla separate form) <br /> zoning <br /> ==. TI5IffattrffRIE <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 /> TOTAL 114.7000 TOTAL 114.5700 <br /> _ <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 /> ===___= <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 /> (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 />