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DCPREZ-0000-04189
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DCPREZ-0000-04189
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Last modified
3/8/2017 3:22:05 PM
Creation date
3/8/2017 3:22:03 PM
Metadata
Fields
Template:
Rezone/CUP
Rezone/CUP - Type
Rezone
Petition Number
04189
Town
Medina Township
Section Numbers
20
AccelaLink
DCPREZ-0000-04189
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ADFP-2 (Rev. 2-1-79) <br /> Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> (1) Name of Owner(s) Hoege Barbara <br /> (Last) (First) (Middle Initial) <br /> (2) Address 5529 Langer Road, Marshall, WI 53559 (3) Phone 655-3981 <br /> • <br /> (4) Location of the land To of Medina Secs 19, 20 8–N 12–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 /> (5) _ Dane 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 October 1, 1980 • <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 /> • <br /> (8) Parcel No. (from tax rolls) (9) Total Acres in parcel (10) Acres in Exclusive Aa. Dicrrict <br /> • <br /> 18-20-469 39.10 39.10 <br /> 18-20-470 39.60 39.60 <br /> 18-20-471 40.1 0 40.10 -, <br /> 18-20-468 30 nn 39.00 -- • <br /> 18-20-465 40.10 40.10 . _ <br /> 18-19-445 38.90 'IR 00 <br /> • <br /> i <br /> l ; <br /> • <br /> •. <br /> L (,‘- ' Al / — <br /> ,I X rL" . <br /> ) ( Li .. <br /> Total 236.80 Total 236.80 <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 /> • <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 /> 1 <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 /> • <br /> 4. <br /> — <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 />
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