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■ • Attach to Wisconsin Income Tax Schedule FC ZONING CERTIFICATE - FARMLAND PRESERVATION ACT - STATE OF WISCONSIN (1) Name of Owners(s) MELTON LLOYD (Last) (First) (Middle Initial) (2) Address 1060 PRAIRIE QUEEN ROAD, CAMBRIDGE, WI (3) Phone 608-423-3302 (4) Location of the land TOWN OF CHRISTIANA 08 06T 12R 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 jurisdistion 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 07/19/79 (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 0612-081-9500-3 38.2000 38.2000 YES 0612-084-9500-0 35.5000 35.5000 NO 0612-081-8000-0 40.0000 40.0000 NO 0612-084-8000-7 40.3000 40.3000 NO TOTAL 154.0000 TOTAL 154.0000 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 effe t fo nds hereby certified. CERTIFICATION --- %. (NOTE: IF ANY OF THE ABOVE INFORMATION HAS CHANGED PL ASE SUBMIT AJ W Z ING E IFICATE.) The undersigned Zoning Authority hereby certifies that th zoning inf tion ' nta' o this form is true and correct on the most recent date shown below. The undersig ed Land ohservati• Conmi (LCC) Authority hereby certifies the above landowner's notification • intent\4submj.0 a cl-'m •e ubch IX, ch. 71, Wis. Stats. 04/26/94 At 04/26/94 1994 Signature of Zoning Authority Date Signatur= ofW'C Authority Date Program Year (The land must be in a certified agricultural zone on Dec. 31 of t e year for which credit is being claimed. This certificate, along with property tax bills, must be included with the Schedule FC en a farmland preservation credit claim is filed with the Wisconsin Department of Revenue). ARM-LR-2 (Rev 9/92)