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ARM•LR-2 (Rev. 11/83) + • <br /> • . Attach to Wisconsin Income Tax Schedule FC <br /> ZONING CERTIFICATE - FARMLAND PRESERVATION ACT - STATE OF WISCONSIN <br /> (1) Name of Owner(s) Olson Kenneth & Barbara <br /> (Last) (First) (Middle Initial) <br /> (2) Mailing Address 10110 USH 14, Black Earth, WI 53515 767-2333 <br /> of Owner ZIP Code (3)Phone <br /> (4) Location of the land Town of Black Earth Secs 22, 23, 26, 27 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 Land Conservation 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 /> X Town under county exclusive agricultural zoning. Local approval date August 15, 1981 <br /> nTown with separate town ordinance. Local approval date <br /> City or village: Check one or both below. <br /> II Within corporate limits. Local approval date <br /> II Extraterritorial. Local approval date <br /> (7) Does each structure or improvement on the land conform to the requirements of the exclusive agricultural zoning ordinance? <br /> Yes I X I 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 /> 03-22-96 3.2 3.2 <br /> 03-22-102 30.3 30.3 <br /> 03-23-120 39.9 39.9 <br /> 03-23-121 39.8 39.8 <br /> 03-26-182 1.7 1.7 <br /> 03-27-200 11.8 11.8 <br /> 03-22-103 2.5 2.5 <br /> 03-22-100 37.9 37.9 <br /> 03-22-97 32. 1 32. 1 <br /> 03-22-83 3.0 3.0 <br /> 03-22-79 3.9 3.q <br /> 03-22-76 14. 4 14.4 <br /> 03-22-70 30.7 30.7 <br /> 03-23-119 2.46 2.46 <br /> 03-22-94 36.2 36.2 _ <br /> Total <br /> 289.86 Total 289.86 <br /> AGRICULTURAL PRESERVATION PLAN <br /> (11) Dane County has adopted an agricultural preservation plan which was certified <br /> • <br /> on (date) 12/4/81 by the State Land Conservation Board. <br /> CERTIFICATION <br /> Signature of Zoning Authority Program Year <br /> Title ZONING ADMINISTRATOR Date <br /> RE-CERTI FICATION <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 />