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, <br /> ,7, 2,/ 9 o <br /> nnv.2-1-79) <br /> Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> 11) Name of Owner(s) <br /> Gustrowsk Flora <br /> (First) (Middle Initial) <br /> (Last) <br /> (2) Address 4365 CTH B, Oregon, WI 53575 <br /> (3) Phone 835-3847 <br /> Town of Dunn Secs. 16,20, 21 6N 10E Dane <br /> (4) Location of the land Section Township, Range County <br /> Town,Village,or City , <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 /> Z by the State Agricultural Lands Preservation Board. <br /> (6) If the land is located in a town,has the town adopted the county exclusive agJunte r l zoning ordinance? <br /> Yes <br /> X No Date of Town Approval <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? <br /> 2 Yes <br /> X No <br /> Land on which tax credit is claimed: <br /> (9) Total Acres in parcel (10) Acres in Exclusive Ag.District <br /> (8) Parcel No. (from tax rolls) <br /> _ __ - -- -------- 39.0000 39.0000 <br /> 0610-203-8020-2 11+,0000 14.0000 <br /> 0610-164-9560-5 � g.11000 33.0000 <br /> 0610-204-850 0-0 40.0 0Q O 40.0000 <br /> 0610-203-950 0-9 3 8.0000 33.0000 <br /> 0610-2 11-8110-3 3`� 50OC) 32•aC100 <br /> 0610-211-950 -9 <br /> 06 10-203-350%l-1 3 5. 0000 35.O35.0000 <br /> 061 3 5.0000 35.0000 <br /> C3-Z 02-13000-7 40.0000 40.0.300 <br /> 0610-202-9500-0 5. 0000 5.0000 <br /> 0610-202-900 0-5 <br /> ' ,-. \ f ) <br /> ;o <br /> Total 316.5 Total <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) __ <br /> Dane County has adopted an agricultural preservation plan which was certified <br /> (date) 12/4/81 by the State Agricultural Lands Preservation Board. Is all of the owner/applicant farmland <br /> located in an agricultural preservation district under the lf certified <br /> acres <br /> are tin the preservation district? - <br /> Yes NO _ —-- — <br /> CERTIFICATION <br /> ATION <br /> 1 <br /> Pro•ram Year <br /> Signature of Zoning Authority: <br /> Title: <br /> ZONING ADMINISTRATOR Date: _ <br /> ----- - --- <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 /> Date Program Year <br /> 1. Title _ <br /> Signature of Zoning Authority __.. <br /> 2. gn_ Title Date Program Year <br /> - <br /> Signature of Zoning Authority <br /> 3. Title <br /> Date Program Year <br /> Signature of Zoning Authority <br /> 4. Title <br /> Date Program Year <br /> Signature of Zoning Authority <br /> (The land p must be in an exclusive included agricultural zone <br /> Schedule FC when credit claims filed with thee Wisconsin leDeparitm Department Revenue., <br /> with property tax bills,must be included w <br />