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Attach to Wisconsin Income Tax Schedule FC ZONING CERTIFICATE - FARMLAND PRESERVATION ACT - STATE OF WISCONSIN (1) Name of Owners(s) TIMM MYRON , A. (Last) (First) (Middle Initial) (2) Address 7020 USH 51 DEFOREST, WI 53532 (3) Phone 609-846-3832 ' (4) Location of the land TOWN OF WINDSOR 21, , , ,09T 10R DANE Town, Village, or City Section, Township, Range County (If part of the owner's farmland is located in another town,village,or city,submit information about that farmland on a separate form) EXCLUSIVE AGRICULTURAL ZONING (5) DANE COUNTY has an exclusive agricultural zoning ordinance which has been certified (County,Town,Village or City) by the State Agricultural Lands Preservation Board. On (date) 12/04/81 (6) Check below the type of ordinance jurisdiction which applies and give the date of local approval(effective date of ordinance). Town under county county exclusive agricultural zoning. Local approval date Town with seperate town ordinance. Local approval date 06/23/93 (7) Does each structure or improvement on the land conform to the requirements 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) Acres in Ex. Ag. District (11) Are improvements in Ex. Ag. Zoning District 0910-212-9130-0 37.9000 37.9000 YES 0910-212-9640-3 9.8750 9.8750 YES TOTAL 47.7750 TOTAL 47.7750 AGRICULTURAL PRESERVATION PLAN AND SOIL AND WATER CONSERVATION STANDARDS (12) DANE County has adopted an agricultural preservation plan which was certified on(date) 12/4/81 by the State Agricultural Lands Preservation Board. DANE County has adopted a soil and water conservation policy which was approved by the State Land Conservation Board on(date) 4/8/86. No notice of noncompliance is in effect for lands hereby certified. CERTIFICATION (NOTE: IF ANY OF THE ABOVE INFORMATION HAS CHANGED PLEASE SUBMIT A NEW ZONING CERTIFICATE.) The undersigned Zoning Authority hereby certifies that the zoning information contained on this form is true and correct on the most recent date shown below. The undersigned Land Conservation Committee (LCC) Authority hereby certifies the above landowner's notification of intent to submit a claim under subch. IX, ch. 71, Wis. Stats. 10/25/94 10/25/94 1993 Signature of Zoning Authority Date Signature of LCC Authority Date Program Year (The land must be in a certified agricultural zone on Dec. 31 of the year for which credit is being claimed. This certificate, along with property tax bills, must be included with the Schedule FC when a farmland preservation credit claim is filed with the Wisconsin Department of Revenue). ARM-LR-2 (Rev 9/92)