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�'r3'(Mw.2•100) - Attach to Wisconsin Income Tax Schedule FC ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN (1) Name of Owner(s) Maurer Gerald H. and Marilyn C. (Last) (First) (Middle Initial) (2) Address 1740 Map1r+ Grovr' Road, Mariiqnn, WT 53711 (3) Phone (60A1 774-F,F,7A (4) Location of the land Verona Secs 11 & 12 T6N 1181,1 Dane Town, Village,or City Section,Township, Range County (/f 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 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 I No Date of Town Approval Janua.ry.6•;'' 1981 (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) (8) Total Acres in parcel (10) Acres in Exclusive Ag. District 0608-1 11-8010-0 3 6.7000 36.7000 0608-111-9500-5 40.0000 40.0000 0608-122-9001-6 36.7000 36.7000 0608-122-955 0-2 1 0.00 00 10.0000 Total 123.4 Total _ 123.4 AGRICULTURAL PRESERVATION PLAN (11) _ . 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? • "ccATIFIr •TION • Signature of Zoning Authority: _ _ _ .—,. . ._ _ Program Year _ Title: ZONING ADMINISTRATOt• 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. 1. • 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 Date Program Year Signature of Zoning Authority Title • (The land must be 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.)