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Douglas County Subdivision Ordinance Variance Appeal Rev 03/2022 DOUGLAS COUNTY PLANNING & ZONING OFFICE 1313 BELKNAP STREET, ROOM 206 / SUPERIOR, WI 54880 PHONE [PHONE REDACTED] / FAX [PHONE REDACTED] NOTICE OF APPEAL OF SUBDIVISION ORDINANCE PLEASE NOTE: You should contact your Town Board Clerk. Be prepared to present your proposal to the Planning Commission and / or Town Board prior to the Zoning Committee public hearing. Date of application: ZC Hearing Date: Property Owner’s Name: Mailing Address: City, State, Zip Telephone: E-mail Address: Property Description: Information must be complete and accurate. Tax Parcel Section________Town_______N_Range_______W_ Town of: Zone District: Property Address: Legal Description: Name of Registered Licensed Surveyor Creating Certified Survey Map (CSM) for Subdivision: ATTACH COPY OF PROPOSED SURVEY OR PLAT SHOWING REQUESTED VARIANCE AND ANY ADDITIONAL INFORMATION. Variance Requested (Refer to 8.1 Subdivision Ordinance and appropriate Zoning Ordinance): Justification for Variance (Describe Unnecessary Hardship): (if more room is required, use the back of this form) The undersigned hereby appeals to the Zoning and Planning Committee for a variance from the 8.1 Subdivision Ordinance, Section IX: *Property Owner or Agent Signature *Date Signed *Printed Property Owner or Agent Name Agent mailing Zoning Committee Decision: Date: Approved Denied Notes: NO. ---PAGE BREAK--- Douglas County Subdivision Ordinance Variance Appeal Rev 03/2022 If this variance is approved: • Submit the Certified Survey Map (CSM) for review / approval by the Douglas County Zoning Administrator and Douglas County Surveyor. • Following review and approval the Certified Survey Map should be recorded in the Douglas County Register of Deeds Office. • After the Certified Survey Map is recorded the Douglas County Property Lister will assign new parcel identification numbers. Type Amount Vendor # Date Paid Receipt # Subdivision Variance Appeal $ 275.00