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APPLICATION FEE $200 VARIANCE APPEAL # 625 ZONING —) <br /> BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 Co. Rd. K, #102 Phone (715) 349-2138 <br /> Siren, WI 54872 <br /> COUNTY OF BURNETT NOTICE OF APPEAL BOARD OF ADJUSTMENT <br /> The undersigned hereby appeal (s) the decision of the Zoning Administrator <br /> denying a land use permit for lands described below which denial has resulted <br /> in unique and undue hardship, and requests that a variance be granted to the <br /> following sections of the Ordinance. <br /> PROPERTY OWNER' S NAME _ 1111 �� lir . a � � � .I'�. �- <br /> APPLICANT NAME )- \ *,-, 'Ak �' �� ���1ti� <br /> ADDRESS Pc \ )o rtk) It )() 2cv12,Qp rR\1�� �fg- <br /> TELEPHONE 1' � Lv- l <br /> LEGAL DESCRIPTION 4-13 1i` i 1)4:9 l 1 <br /> FIRE # ROAD NAME <br /> VARIANCE REQUESTED ap( ��'�� ' c�J <br /> P>o* <br /> JUSTIFICATION FOR VARIANCE t LA <br /> LJ4.-\ ' il\ , <br /> NAMES AND ADDRESSES OF ADJOINING PROPERTY OWNERS: 3� 3 ri e � <br /> . �hlst-rtTrn , � Da�labur y,� 5�/83c <br /> 7, � 14- - '� �Baa--(� <br /> apf5 jf)* !3-b-14/0 Lk <br /> Ger K: 10 r el , 1�' (I er , 9,s3 o et), 614177 <br /> Chal Kr 8 cc;ne L4 Pcfoonei1 <br /> bnef pi= 5Ztxo <br /> **A PLOT PLAN DRAWING SHOWING THE COMPLETE LOT LAYOUT WITH SETBACKS AND <br /> DIMENSIONS MUST ACCOMPANY THIS APPLICATION** <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> information contained in this application (including any accompanying schedule) and I further declare that I recognize that <br /> this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a <br /> permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am providing <br /> in this application. I agree to permit county officials charged with administering county ordinances or other authorized person <br /> to have access to the above described premises at any reasonable time for the purpose of inspection. <br /> SIGNATURE OF APPLICANT <br /> ACTION TAKEN BY APPEAL BOARD: <br /> SIGNED (CHAIRMAN) DATE <br />