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ADFP 2(Rev. 2 1 79) Attach to Wisconsin Income lux Schedule h'(' ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN (1) Name of Owner(s) _. Weum Delbert (Last) (First) (Middle Initial) (2) Address _._ _R#2, 2289 STH 73, Cambridge, WI 423-3070 — — —— — --- (3) Phone Town of Christiana Secs 21 & 22 6—N 12—E Dane (4) Location of the land_.__.__ 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 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. (6) If the land is located in a town, has the town adopted the county exclusive agricultural zoning ordinance? Yes _. .. + ___ . No ___—.___ __._ Date of Town Approval 1 9 1 9 7 _ (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 Exclusive Ag. District 0612-211-9540-7 1 2.20 00 12.2000 0612-211-3000-2 1 1.2000 11.2000 0612-223-3500--3 3 3.600'0 .0000 Total 62.0 — Total 23.4 AGRICULTURAL PRESERVATION PLAN 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 district? CERTIFICATION Program Year — Signature of Zoning Authority: ZONING ADMINISTRATOR Title: .. -- — — -- Date: RE-CERTIFICATION (Note: If any of tire 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 3. -- 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 for which credit is being claimed. This certificate, along with property tax bills, must be included with the Schedule FC when credit claim is filed with the Wisconsin Department of Revenue.)