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Petition for Amendment to Douglas County Zoning Ordinance Rev 03-2022 DOUGLAS COUNTY PLANNING & ZONING OFFICE 1313 BELKNAP STREET, ROOM 206 / SUPERIOR, WI 54880 PHONE [PHONE REDACTED] / FAX [PHONE REDACTED] PETITION FOR AMENDMENT TO DOUGLAS COUNTY ZONING ORDINANCE Date of application: ZC Hearing Date: TO THE DOUGLAS COUNTY BOARD OF SUPERVISORS AND ZONING COMMITTEE: The Petitioner hereby petitions you pursuant to Wis Stat. § 59.69(5)(e)1, to amend the Zoning District Map of the Douglas County Zoning Ordinance by reclassifying the property as shown and stated below: 1. Requested Zone Change: From (Zone District): To (Zone District): 2. Property Description: Information must be complete and accurate. Tax Parcel Section________Town_______N_Range_______W_ Town of: Property Address: Legal Description: 3. Portion of Lot / Parcel Affected by Zone Change Request: Lot / Parcel Size: Length: Width: Acres: Area to be Re-Zoned: Length: Width: Acres: 4. Property Owner: Property Owner’s Name: Mailing Address: City, State, Zip Telephone: E-mail Address: 5. Petitioner requests this amendment for a proposed property use of: 6. In making this petition, Petitioner gives permission for an inspection of the above-stated site by the Douglas County Office of Zoning Administration and/or Zoning Committee, and will allow photographs to be taken of the same if necessary. 7. Contact the Town Clerk to place this application on the Town Board agenda prior to scheduled Zoning Committee hearing as required by Sec. 59.69(5)(e) 3 Wis Stats. (Continued on reverse) NO. ---PAGE BREAK--- Petition for Amendment to Douglas County Zoning Ordinance Rev 03-2022 8. A dimensional diagram of the property is as shown below: *Property Owner or Agent Signature *Date Signed *Printed Property Owner or Agent Name Type Amount Vendor # Date Paid Receipt # Zone Change $ 275.00 Zoning Committee Decision: Date: Approved Denied County Board Decision: Date: Approved Denied