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Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> (1) Name of Owner(s) Olson Walter J. & Irene R. <br /> (Last) (First) (Middle Initial) <br /> (2) Mailing Address <br /> of Owner 720 London Road, Deerfield, WI ZIP Code 53531 (3)Phone 764-8333 <br /> (4) Location of the land Deerfield Secs 27,28,33 + 34 7N 12E 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 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) 5/18/78 <br /> (6) Check below the type of ordinance jurisdiction which applies and give the date of local approval (effective date of ordinance). <br /> IXI Town under county exclusive agricultural zoning. Local approval date <br /> Town with separate town ordinance. Local approval date <br /> I_I City or village: Check one or both below. <br /> nWithin corporate limits. Local approval date <br /> [1 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 I ^I No fl <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 /> 12-27-622 39.8 39.8 <br /> 12-27-623. 1 35.6 35.6 <br /> 12-27-627.1 25.2 25.2 <br /> 12-27-628. 1 36.2 36.2 <br /> 12-28-650 19.6 18.2 <br /> 12-33-725 40.5 40.5 <br /> 12-33-728 40.5 40.5 <br /> 12-34-753 20.2 20.2 <br /> 12-34-756 40.4 40.4 <br /> 12-34-757 40.4 40.4 <br /> Total 338.4 Total 337.1 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) Dane County has adopted an agricultural preservation plan which was certified <br /> on (date) 12/4/81 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 /> ARM-LR-2(Rev 11/86) <br />