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ADFP-2(Rev. 1=83) ALSO: Fitchburg <br /> Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> (1) Name of Owner(s) 'Mph off. ,Tr. Fred <br /> (Last) (First) (Middle Initial) <br /> (2) of Mailing Address 4561 Meadowview Road, Madison, WI 53711 222-•5029 • <br /> of Owner ZIP Code (3)Phone <br /> (4) Location of the land Town of Dunn Sec 6 6N 10E <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 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 /> Town under county exclusive agricultural zoning. Local approval date June 7, 1978 <br /> ❑ Town with separate town ordinance. Local approval date <br /> ❑ City or village: Check one or both below. <br /> EWithin corporate limits. Local approval date <br /> ❑ Extraterritorial. Local approval date <br /> • <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? <br /> Yes © No r <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 /> 14-06-72 13.4 13.4 <br /> 14-06-68 39. 0 39.0 <br /> 14-06-69 43.0 43.0 <br /> Total 95.4 Total 95.4 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) County has adopted an agricultural preservation plan which was certified <br /> on (date) by the State Agricultural Lands Preservation Board. <br /> CERTIFICATION <br /> • <br /> Signature of Zoning Authority Program Year <br /> Title 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 /> • <br />