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ADF P-2 (Rev.3-1-78) <br /> Attach to Wisconsin Income Tax Schedule PC <br /> ZONING CERTIFICATE — FARMLAND PRESERVATION ACT — STATE OF WISCONSIN <br /> (1) Name of Owner(s) Jenson & Quam Sharon & Patricia <br /> (Last) (First) (Middle Initial) <br /> (2) Address R#1, 1555 Drotning, Stoughton, WI 53589 873-9820 <br /> (3) Phone <br /> (4) Location of the land Town of Deerfield Secs 28 & 29 7—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 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 October 26, 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 /> 12-29-668 17.1 17.1 <br /> 12-29-666 20.1 20.1 <br /> 12-28-642 40.8 40.8 <br /> 12-28-644 7.5 7.5 <br /> 12-28-639 35.8 35.8 <br /> Total 121.3 Total 121.3 <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 _ K 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 /> 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 />