TOWN OF CLOVERLAND – APPLICATION FOR SETBACK VARIANCE
OWNER’S
NAME _______________________________________________________
APPLICANT’S
NAME (IF
DIFFERENT FROM OWNER) ________________________________________
MAILING
ADDRESS ____________________________________________________
CONTRACTOR’S
NAME __________________________________________________
TELEPHONE
NUMBER __________________ E-mail ___________________________
TAX
PARCEL NO: _________ COMPUTER NO:
____________
PROPERTY
ADDRESS/FIRE # _____________________________________________
LEGAL
DESCRIPTION ___ 1/4 ___ 1/4 OR GOV’T.
LOT ___, SECTION ____, T40N, R9E
APPROXIMATE
LOT DIMENSIONS ____ X ____ LOT AREA ____ SQ.FT./ACRES
ZONING
DISTRICT ____________________________________________________
CURRENT
USE & IMPROVEMENTS _________________________________________
PROPOSED
USE & IMPROVEMENTS ________________________________________
TO QUALIFY FOR A VARIANCE, APPLICANT MUST PROVE 3 REQUIREMENTS LISTED BELOW:
ATTACH SCALED DRAWING OF THE PROPERTY SHOWING EXISTING STRUCTURES, PROPOSED STRUCTURES WITH DIMENSIONS TO LOT LINES & PUBLIC ROADS.
ATTACH
DRIVING DIRECTIONS FROM THE TOWN HALL TO THE PROPOERTY
STAKEOUT
THE PROPOSED BUILDING FOR INSPECTION BY THE TOWN BOARD
I
CERTIFY THAT THE INFORMATION I HAVE PROVIDED IN THIS APPLICATION IS TRUE & CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF.
SIGNED
(APPLICANT/AGENT/OWNER) _____________________________________
DATE
_______________________________________________________________
Return Completed Application To:
Millie Ritzer
Clerk - Town of Cloverland
PO Box 1565
Eagle River WI. 54521