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Local_bridge_program_entitlement_application 84.18: Local bridge program entitlement application

The following statutes affect this form: s. 84.18, Wis. stats.

STATE OF WISCONSIN
Town of ________
________ County

To the County Board of ________ County, Wisconsin:

The Town Board of the Town of ________, ________ County, Wisconsin, applies for fund entitlement under s. 84.18, Wis. stats., to [reconstruct or rehabilitate] a seriously deteriorating local bridge in the Town of ________ located on ________ [give highway name, or otherwise describe] in the County of ________, district ________, and bridge number ________, of construction type ________. The type of work required is [describe as required by Dept. of Transportation] and the estimated total funds required is $________.

Dated this ______ day of ________, 20__.

[Signatures of town board]

Attest: [Signature of town clerk]

Note: For additional information see the Department of Transportation website at the following address:

http://wisconsindot.gov/Pages/doing-bus/local-gov/astnce-pgms/highway/localbridge.aspx