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• <br /> Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> John T. & <br /> (1) Name of Owner(s) McFee Donaldson <br /> (Last) (First) (Middle Initial) <br /> (2) Mailing Address 767-3329 <br /> of Owner 4136 STH 78 N. , Mt. Horeb, WI ZIP Code 53577 (3)Phone 767-3419 <br /> (4) Location of the land Vermont . Section 13 7N 6E <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,please submit information about that farmland on a separate form.) <br /> EXCLUSIVE AGRICULTURAL ZONING <br /> (5) Dane has an exclusive agricultural zoning ordinance which has been certified <br /> (County,Town,Village or City) <br /> by the State Land Conservation Board on (date) c/18/78 • <br /> (6) Check below the type of ordinance jurisdiction which applies and give the date of local approval (effective date of ordinance). <br /> © Town under county exclusive agricultural zoning. Local approval date 10/1 9/79 <br /> ❑ Town with separate town ordinance. Local approval date <br /> ❑ City or village: Check one or both below. <br /> 0 Within corporate limits. Local approval date <br /> ❑ Extraterritorial. Local approval date <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? <br /> Yes © No ❑ <br /> Land on which tax credit is claimed: <br /> (8) Parcel No. (from tax rolls) (9) Total Acres in Parcel (10) Acres in Exclusive Ag. District <br /> 0706-134-8000-7 40.0 40.0 <br /> 0706-131-9720-7 10.0 10.0 <br /> 0706-134-8570-8 30.0 30.0 <br /> 0706-131-9000-8 40.0 40.0 <br /> /SJ <br /> fps <br /> Total 120 0 Total 120.0 <br /> AGRICULTURAL PRESERVATION PLAN <br /> • (11) Dane County has adopted an agricultural preservation plan which was certified <br /> on (date) 1214/81 by the State Land Conservation Board. <br /> SOIL AND WATER CONSERVATION POLICY <br /> (12) Dane County Land Conservation Committee has adopted a soil and water conservation <br /> policy which was approved on (date) April 6, 1986 by the State Land Conservation Board. No notice of <br /> noncompliance is in effect for lands hereby certified. <br /> CERTIFICATION <br /> Signature of Zoning Authority Program Year <br /> Title ZONING ADMINISTRATOR Date <br /> RE-CERTIFICATION <br /> (Note:If any of the above information has changed,please submit a new zoning certificate.) <br /> The undersigned hereby certifies that the information contained on this form is true and correct on the most recent date shown below. <br /> 1. <br /> Signature of Zoning Authority Title Date Program Year <br /> 2. <br /> Signature of Zoning Authority Title Date Program Year <br /> 3. <br /> Signature of Zoning Authority Title Date Program Year: <br /> 4. <br /> Signature of Zoning Authority Title Date Program Year <br /> (The land must be in an exclusive 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 credit claim is filed with the Wisconsin Department of Revenue.) <br />