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Attach to Wisconsin Income Tax Schedule FC ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN (1) Name of Owners) Olson Walter 3. & Irene R. (Last) (First) (Middle Initial) (2) Mailing Address of Owngr 720 London Road, Deerfield, WI ZIP Code 53531 (3)Phone 764-8333 (4) Location of the land Deerfield Secs 27,28,33 + 34 7N 12E Dane j 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 has an exclusive agricultural zoning ordinance which has been certified (County, Town, Village or City) by the State Land Conservation Board on (date) 5/18/78 (6) Check below the type of ordinance jurisdiction which applies and give the date of local approval (effective date of ordinance). XI Town under county exclusive agricultural zoning. Local approval date II Town with separate town ordinance. Local approval date City or village: Check one or both below. Within corporate limits. Local approval date Extraterritorial. Local approval date (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? Yes I XI No I Land on which tax credit is claimed: (8) Parcel No. (from tax rolls) (9) Total Acres in Parcel (10) Acres in Exclusive Ag. District 0712-272-9500-0 3 9. 8000 39.8000 0712-273-800 1-5 3 5.6000 35.6000 0712-273-9070-0 25. 2000 25.2000 0712-273-9501-8 36. 2000 36.2000 0712-284-9501-5 18.2000 18.2000 0712-331-3000-5 40. 5000 40.5000 0712-331-950 0-3 40. 5000 40.5000 0712-341-8570-4 20. 2000 20.2000 0712-342-8000-2 40.4000 40.4000 0712-34273500-7 4-0.4000 40.4000 Total 337.000 Total 337.000 AGRICULTURAL PRESERVATION PLAN (11) Dane County has adopted an agricultural preservation plan which was certified on (date) 12/4/81 by the State Land Conservation Board. SOIL AND WATER CONSERVATION POLICY (12) Dane County Land Conservation Committee has adopted a soil and water conservation policy which was approved on (date) April 6, 1986 by the State Land Conservation Board. No notice of noncompliance is in effect for lands hereby certified. CERTIFICATION Signature of Zoning Authority Program Year Title ZONING ADMINISTRATOR 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. Signature of Zoning Authority Title Date Program Year (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.) ARM-LR-2(Rev 11/86)