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ADFP-2(Rev.3.1-78) <br /> Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> (1) Name of Owner(s) Reindahl Donald <br /> (Last) (First) (Middle Initial) <br /> (2) Address RR#2, Oregon, WI 53575, 4420 Oak Hill (3) Phone 835-3215 <br /> (4) Location of the land Town of Rutland Sec 8 5—N 10—E Dane <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 County has an exclusive agricultural zoning ordinance which has been certified <br /> (County,Town, Village or City) <br /> by the State Agricultural Lands Preservation Board. <br /> (6) If the land is located in a town,has the town adopted the county exclusive agricultural zoning ordinance? <br /> Yes —X No Date of Town Approval June 7, 1978 <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? t; :-. <br /> Yes X No <br /> Land on which tax credit is claimed: <br /> (8) Parcel No. (from tax rolls) _�__(9) Total Acres in parcel ____ Acres in Exclusive Ag. District <br /> 0510-083-8000-4 40.0000 40.0000 <br /> 0510-083-8790-9 3.2500 3.2500 <br /> 0510-083-9000-2 27.2000 27.2000 <br /> 0510-083-9500-7 40.0000 40.0000 <br /> Total 110.45 Total 110.45 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) County has adopted an agricultural preservation plan which was certified <br /> (date) by the State Agricultural Lands Preservation Board. Is all of the owner/applicant farmland <br /> located in an agricultural preservation district under the certified county preservation plan? <br /> Yes No If NO, how many acres are in the preservation district? <br /> CERTIFICATION <br /> Program Year — <br /> Signature of Zoning Authority: <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' — Date Program Year <br /> Signature of Zoning Authority Title <br /> 2. ------. — Date Program Year <br /> Signature of Zoning Authority Title <br /> 3 Date Program Year <br /> Signature of Zoning Authority Title <br /> 4. I <br /> Date Program Year <br /> Signature of Zoning Authority Title <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 />