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ADFP-2(R,ev.-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) Gobel Mario - <br /> (Last) (First) (Middle Initial) <br /> (2) Address 7263 CTH A', Belleville, WI 53508 - (3) Phone 424-6284 <br /> (4) Location of the land Town of Montrose Secs 16, 21 & 22 5N-8E 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 September 11, 1978 <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 /> 20-16-358 40.0 40.0 <br /> 20-16-363 40.0 40.0 <br /> 20-16-364 40.0 40.0 <br /> 20-16-368 40.0 40.0 <br /> 20-16-370 40.0 40.0 <br /> 20-16-371 40.0 40.0 <br /> 20-16-372 40.0 40.0 - . <br /> 20-21-448 40.0 40.0 __*____. ___. <br /> 20-21-449 40.0 40.0 , <br /> 20-21-450 40.0 40.0 <br /> 20-21-451 27.5 27.5 - <br /> 20-22-479 27.0 (U�ii 27.0 <br /> 20-22-480 4.2 IS S t` 4.2 <br /> ( kit' 11 <br /> (,0 / / 1 s'z' <br /> Total 458.7 Total 458.7 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) 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 /> 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 /> • <br /> (The land must be in an exclusive agricultural zone on Dec. 31 of the year Jor 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 />