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G 03 <br /> 04 Attach to Wisconsin Income Tax Schedule FC <br /> • c+, •__y~ j C u-n guicatI'O:pAT acReczoweg OF WISCONSIN <br /> 1' '� '/1 Roomili, E� 6 ounty Building, Madison, Wiss� is OL9. Land Division Review <br /> (1) V' :�,y,grT ers(s) <br /> ht ScoNS s bU bb-yUFSb <br /> �`�.��.��_-__ (Last) (First) (Middle Initia��j <br /> (2) Address 2466 CTH N, STOUGHTON, WI 53589 (3) P& egf !g9g6994 <br /> GARY P. GUNDERMAN <br /> 8/ b-41 <br /> (4) LoB.t iem of the land TOWN OF PLEASANT SPRINGS 16 06T 11R 808 26�.� <br /> Town, Village, or City Section, Township, Range County <br /> (If part of the owner's farmland is located in another town,village,or city,submit information about that farmlang0 gP rate form) <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 06/06/78 <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 /> 0611-164-8215-3 5.0000 5.0000 NO <br /> 0611-164-8501-6 39.2500 39.2500 YES <br /> TOTAL 44.2500 TOTAL 44.2500 <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 /> 07/05/94 C O I' y 07/05/94 1993 <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). <br /> ARM-LR-2 (Rev 9/92) <br />