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P 2 Res 21 79) Attach to Wisconsin Income Tax Schedule FC ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN (1) Name of Owner(s) Gehin - Paul + Jacqueline + John + Cynthia (Last) (First) (Middle Initial) (2) Address 1008 Severson. Road, Belleville_, WI 5350$ (3) Phone _ 424-6269 (4) Location of the land_ Town of Montrose Secs 13 & 24 5-N 8-E 'Dane Town, Village,or City Section,Township, Range County- (If part of the owner's farmland is located in another town, village,or city,please submit information about that farmland on a separate fort.) 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. • (6) If the land is located in a town, has the town adopted the county exclusive agricultural zoning ordinance? Yes X No Date of Town Approval September 11. 1978 (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: i • (8) Parcel No. (from tax rolls) (9) Total Acres in parcel ' '(10) Acres'in Exclusive Ag.District- _ 0508-132-8000-9 40.0000 40.0000 0508-132-8660-1 3 0.0000 30.0000 0508-132-9000-7 40.0000 40.0000 0508-133-8000-8 3 7.00 00 37.0000 0508-133-8500-3 25.5000 25.5000 0508-133-900 0-6 4 0.0000 40.0000 0508-133-9500-1 40.0000 40.0000 0508-242-8510-9 3 7.5000 37.5000 0508-242-9050-4 3.4000 3.4000 Total 293.4 Total 293.4 AGRICULTURAL PRESERVATION PLAN (1 1) Dane County has adopted an agricultural preservation plan which was certified (date) 12/4/81 by the State Agricultural Lands Preservation Board. Is all of the owner/applicant farmland located in an agricultural preservation district under the certified county preservation plan? Yes No If NO, how many acres are in the preservation disttict? - — — c CERTIFICATION , • Signature of Zoning Authority: _ —_._ Program Yeah_= - Title: ZONING ADMINISTRATOR __ Date:___-_ —- RE-CERTIFICATION (Note:if any of the above information has changed,please submit a new zoning certificate.) The undersigned hereby certifies that the information contained on this form is true and correct on the most recent date shown below. Signature of Zoning Authority Title Date Program Year 2. _... ..--- - Signature of Zoning Authority Title Date Program Year ----- Signature of Zoning Authority Title Date Program Year 4. - - ---__ ------._ . .- --- ------ Signature of Zoning Authority Title Date Program Year (The land must he in an exclusive agricultural zone on Dec. 31 of the year JOr whic/t credit is being claimed. This c•ertif wale, along with property tax bills, must be included with the Schedule l"C'when credit claim is filed with the Wisconsin Department of Revenue.)