AGRICULTURAL EXEMPTION
AFFIDAVIT
NOW COMES_____________________________, having first been duly sworn
according to law,
says that:
1.
I am
the owner/legal possessor of real property consisting of _______ acres located
at
_______________________________, in the ______ quarter of Section
_______ of
2.
My
mailing address is
_______________________________________________________;
3.
I
hereby declare that the building identified on the attached plot plan of
the
subject property will be strictly used for agricultural purposes, and any
change in the use
of this building other than agricultural will require approval from the
Chippewa Township
Zoning Inspector, and may require approval by the Board of Zoning
Appeals, and
permission may be revoked upon a change to non-agricultural use in the
discretion of the
Zoning Inspector.
4. The property listed in item #1 is/is not currently listed as CAUV. (Please circle).
5. The building size is _____________________.
6. The building height is ___________________.
7. The current agricultural use of this property is (list use such as crops, hay, pasture, etc.).
______________________________________________________________________.
8. The agricultural use of this building or structure is (list use such as farm equipment
[type, etc.], animals, feed, etc.)
_____________________________________________________________________
______________________________________________________________________
______________________________________________________________________.
9.
I hereby declare that this building is exempt from zoning. I, my successors and
heirs
also hereby agree to annual inspections of this building to verify
conformance with this
Affidavit that the use is agricultural. I understand that if the actual
use of this building fails
to be or ceases to be agricultural, the Zoning Inspector, at his/her
discretion, may revoke this
approval.
10. I declare under penalty of perjury that the foregoing is true and correct.
FURTHER AFFIANT SAYETH
NAUGHT
_______________________________________
Affiant
STATE OF
) SS:
SWORN TO BEFORE ME, and signed in my presence this _____day of ___________________, _______,
______________________________________
Notary Public
(seal) My Commission Expires: _________________
AGRICULTURAL EXEMPTION STATEMENT
I am causing the building at the above location to be constructed for
agricultural use. If I change the
use of this building, I will obtain the
necessary permits and necessary inspections.
I authorize the Chippewa Township Zoning Inspector to come onto my
property and to make periodic
inspections as necessary, to insure compliance
with the agricultural exemption statement.
_______________________ ______________________________
Date Signature of Owner/Applicant
Approved by ______________________________
Larry LeMaster, Zoning Inspector
_______________________
Date
APPROVAL
I, the Zoning Inspector of Chippewa Township, have reviewed the above
Agricultural Exemption
Affidavit. I have inquired as to the truth and veracity
of that Affidavit and have ascertained the property is
either CAUV or that
there is an appropriate agricultural use for the property and, therefore, I
approve this
Agricultural Exemption Affidavit so that the property may be
used for agricultural use only.
________________________ _____________________________
Date Zoning Inspector
CTZON200701AGEXEMPTAFFIDAVIT