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• <br /> 4 of;.\\ Attach to Wisconsin Income Tax Schedule FC <br /> / ) �i�',G CE - - tATE OF WISCONSIN <br /> ; A—___= ii U , f!HI rbp I I I—EITT <br /> (1)'ii z, ners(s) •.... :L 0�.� _r• . _ . ..sib „_•• •• A ' •!�:_.• • •e•& PATRIC ' .,. . _ <br /> 114 oN5?>e (Last) (First) (Middle Ini6h e'Q41g086 <br /> (2) ^:.c,_:---- 6729 PATTON RD. , WAUNAKEE, WI 53597 <br /> (3) y60-0000 <br /> 608/266-4120 <br /> (4) Location of the land TOWN OF VIENNA 28 09T 091tulvoy8tl1NE <br /> Town, Village, or City Section, Township, Range 608/266-402unty <br /> (If part of the owner's farmland is located in another town,village,or city,submit information about that farmlarnAcreparate form) <br /> latalierarxikirzem <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 01/21/80 <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 /> 0909-284-8140-7 8.2000 8.2000 <br /> 0909-284-8190-7 20.0500 20.0500 <br /> 0909-284-8500-1 40.2000 40.2000 <br /> 0909-284-9000-4 40.2000 40.2000 <br /> 0909-284-9500-9 40.7000 40.7000 <br /> TOTAL 149.3500 TOTAL 149.3500 <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. Stats. <br /> 10/04/94 10/04/94 0000 <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). LJ <br /> ARM-LR-2 (Rev 9/92) <br />