PETITION

SAMPLE PETITON TO THE TOWN (COUNTY) BOARD OF SUPERVISOR

To the Town (County) of______

WE, THE UNDERSIGNED, HEREBY PETITION the ______Town (County) Board of Supervisors to establish a public inland lake protection and rehabilitation district pursuant to authority vested in it by Chapter 33, Wisconsin Statutes.

WE STATE OR BELIEVE:

1.  That the petitioners are owners of land to be included within the proposed district.

2.  That the district, if established, shall be known as Lake______District (______Lake District).

3.  That the proposed district is necessary to define the present and anticipated problems of ______lake and to identify their causes and to implement various remedial measures to deal with the problems and to undertake activities such as protection of the fishery, maintenance of appropriate lake levels, control of aquatic weeds, reduction of sedimentation, and promotion of harmonious use of the lake’s surface.

4.  That the public health, comfort, convenience, necessity or public welfare will be promoted by the establishment of the district.

5.  That the lands to be included within the district will be benefited by the establishment of the district, and that the lands proposed for inclusion are:

(legal description of lands with proposed district.)

The boundaries of the land described above are shown on an attached sketch (plat) indicating the approximate area and boundaries of the proposed district and incorporated as part of this petition.

Signature of Signer Name Legal Address Date

______

______

(Lines for signatures continue)

(This affidavit should appear on each sheet that includes signature lines.)

STATE OF WISCONSIN Affidavit of Petition

COUNTY OF______Circulator

______, being duly sworn, deposes and says that he or she is an owner of land within the boundaries of the proposed district; that to the best of his or her knowledge, all persons who have signed the foregoing petition are landowners within the boundaries of the proposed district and that the accompanying map and description indicates the territory to be included in the proposed district and that the petition has been signed by persons constituting 51 percent or more of the landowners within the proposed district.

Signature of Petition Circulator______

PO Address

City

Subscribed and sworn to before me this _____day of ______, 19____.

______

Signature of Notary

My commission expires