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AoFP 2(R•v.2 1 701 <br /> Attach to Wisconxiu Income Tax Schedule Fe <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN ' <br /> (1) Name of Owner(s) Dahmen - Gilbert = <br /> (Last) (First) (Middle Initial) <br /> (2) Address _ 7421 Kickaboo Road, Waunakee, WI 53597 (3) Phone 831-8354 <br /> (4) Location of the land - Town of Springfield --__ Secs 17 & 20 8-N 8-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 /> 151 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 —_ April 16, 1979_- <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? • <br /> Yes ....X.____ 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 /> 28-17-416 40.0 40.0 <br /> 28-17-413 40.0 40.0 <br /> • <br /> 28-20-461 40.0 40.0 <br /> • <br /> Total 120.0 Total 120.0 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (111 -_ __ 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 certified county preservation plan? . <br /> Yes ______ No If NO, how many acres are in the preservation district?_ • <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 /> Signature of Zoning Authority Title • Date Program Year <br /> 2. ____-.------ <br /> .. -----•--_. .._ .__.. Date Program Year <br /> Signature of Zoning Authority Title <br /> 3. —• -- - - -..— -- Date Program Year <br /> Signature of Zoning Authority Title <br /> 4. — — — — Date Program Year <br /> Signature of Zoning Authority Title <br /> (The land must he 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 />