The following is a general outline of the proposed improvement: [give general outline].
Dated this ______ day of ________, 20__.
[Signatures of petitioners]*
Verification
STATE OF WISCONSIN
________ County
________ ________, being first duly sworn, states on oath that [he or she] is one of the above petitioners, that the above petition was signed personally by the petitioners, and that the above petition is true and correct to the affiant’s own knowledge, except as to matters stated on information and belief, which the affiant believes to be true.
[Signature of affiant]
Subscribed and sworn to before me this ____ of ________, 20__.
[Signature and title of officer]
Notes: If a proposed sanitary district is within more than one town, the town board with the largest portion of the equalized value of taxable property within the district has exclusive jurisdiction to establish the sanitary district. The verification may be signed by one of the petitioners before any of the officials listed in s. 887.01 (1), Wis. stats. The petition must be filed with the town clerk. Section 60.71 (2) (b), Wis. stats., provides, “One or more of the petitioners shall verify that the petition was signed personally by the persons whose signatures appear on the petition, or a person who signs a petition may have his or her signature notarized.” When signatures are notarized, appropriate attestation by the notary must be added, such as: Personally came before me this ________ day of _____, 20__, ________ ________, of the Town of ________, ________ County, Wisconsin, known to me to be the person who signed this petition, and acknowledged the same.
[Signature of notary public]
Notary Public, State of Wisconsin
My commission _________.
The following statutes affect this form: s. 60.71 (3), Wis. stats. We, [state the name of the principals], as principals, and [state the name of the sureties], as sureties, of ________ County, Wisconsin, jointly and severally undertake and agree that the principals will pay to the Town of ________, ________ County, Wisconsin, all the expenses connected with the proceedings upon the petition of the principals to establish a town sanitary district in the town as provided by s. 60.71, Wis. stats., in case the town board refuses to establish a sanitary district. [Signatures and seals]
In presence of:
[Signatures of 2 witnesses]
Approval of Bond
The above bond was approved by the Town Board of the Town of ________, ________ County, Wisconsin, at its meeting held on ________ ___, 20__.
[Signature of town clerk]
The following statutes affect this form: s. 60.71 (4) (b), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
Notice is hereby given that a hearing on a petition for the establishment of a town sanitary district, to be known as Town Sanitary District No. ____ of the Town[s] of ________, ________ County, Wisconsin, will be held at ______________ [town hall or some other proper place] at ____ o’clock ___m., on ________ ___, 20__. The boundaries of the proposed district are as follows: [define boundaries].
Dated this ______ day of ________, 20__.
[Signature of town clerk]
Note: Notice of hearing must be published as a class 2 notice under ch. 985, Wis. stats., and mailed at least 10 days prior to the hearing to the State of Wisconsin, Department of Safety and Professional Services and Department of Natural Resources. The following statutes affect this form: s. 60.71 (6) (c), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
A petition, addressed to the Town Board of the Town of ________, ________ County, Wisconsin, requesting the establishment of a town sanitary district in the Town[s] of ________, ________ County, Wisconsin, having been filed with the clerk of the Town of ________, ________ County, Wisconsin, and on proper notice a public hearing having been held on the petition at ______________ on ________ ___, 20__, and the bond required by law having been filed and approved; and
After consideration of all objections to the proposal and the reasons in favor of it, the undersigned Town Board of the Town of ________, ________ County, Wisconsin, declare and find that the petition is signed by the requisite owners of real estate, as provided in s. 60.71 (2), Wis. stats., that the proposed work is necessary, that the public health, safety, convenience, and welfare will be promoted by the establishment of a town sanitary district, and that the property included in the district will be benefited by the establishment of the district; Now, therefore, it is ordered that a town sanitary district is hereby organized. The corporate name of the district is Town Sanitary District No. ____ of the Town[s] of ________, ________ County, Wisconsin. The boundaries of the town sanitary district are established as follows: [describe boundaries].
Dated this ______ day of ________, 20__.
[Signatures of town board]
Note: A copy of the order must be filed with the State of Wisconsin, Department of Natural Resources and the register of deeds of the county where the district is located. See s. 60.71 (7), Wis. stats. The following statutes affect this form: s. 60.74 (4), Wis. stats. Petition
To ________ ________, clerk, Town of ________, ________ County, Wisconsin:
The undersigned electors of Town Sanitary District No. ____ of the Town[s] of ________ petition the Town Board of the Town of ________, ________ County, Wisconsin, that the sanitary district commissioners be elected instead of appointed. The commissioners shall first be elected at [a special election or the spring election] as provided in s. 60.74 (4), Wis. stats. Affidavit
STATE OF WISCONSIN
Town of ________
________ County
________ ________, of [insert address of residence with street and number], being duly sworn, says that I personally circulated the petition and personally obtained each of the signatures; that I know that the signers are electors of the jurisdiction or district in which the petition is circulated; that I know that the signers signed the paper with full knowledge of its content; that I know the signers’ respective residences given; that I know that each signer signed on the date stated opposite his or her name; that I reside within the jurisdiction or district in which the petition is circulated; and that I am aware that falsifying this affidavit is punishable under ss. 12.13 (3) (a) and 946.32 (1) (a), Wis. stats. Subscribed and sworn to before me this ____ of ________, 20__.
[Signature of officer administering oath]
Note: The petition must be signed by qualified electors of the districts equal to at least 20% of the votes cast for governor in the district at the last gubernatorial election. See s. 60.74 (4) and (6), Wis. stats. The following statutes affect this form: s. 60.74 (5), Wis. stats. Petition
To ________ ________, clerk, Town of ________, ________ County, Wisconsin:
The undersigned electors of Town Sanitary District ________ of the Town[s] of ________ petition the Town Board of the Town of ________, ________ County, Wisconsin, that the district commissioners be appointed instead of elected.
Affidavit
STATE OF WISCONSIN
________ County
________ ________, of [insert address of residence with street and number], being duly sworn, says that I personally circulated the petition and personally obtained each of the signatures; that I know that the signers are electors of the jurisdiction or district in which the petition is circulated; that I know that the signers signed the paper with full knowledge of its content; that I know the signers’ respective residences given; that I know that each signer signed on the date stated opposite his or her name; that I reside within the jurisdiction or district in which the petition is circulated; and that I am aware that falsifying the affidavit is punishable under ss. 12.13 (3) (a) and 946.32 (1) (a), Wis. stats. [Signature of affiant]
Subscribed and sworn to before me this ____ of ________, 20__.
[Signature of officer administering oath]
Note: For number of required signatures, see the note to 60.74 (4): Petition to elect, instead of appoint, sanitary district commissioners.
Beverages and Tobacco
The following statutes affect this form: s. 66.0433, Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
________ ________, having produced to the undersigned, town clerk of the Town of ________, a receipt showing the payment of $________ to the treasurer of the town, in conformity with an order of the board made on ________ ___, 20__;
This is to certify that in pursuance of the order, a license is granted to ________ ________ to sell at [retail or wholesale] beverages containing less than one-half of one percent of alcohol by volume, on the following described premises: [describe].
This license will expire on ________ ____, 20__, unless sooner revoked.
Dated this ______ day of ________, 20__.
[Signature of town clerk]
The following statutes affect this form: s. 66.0433 (1), Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
Whereas, ________ ________, of the Town of ________, ________ County, Wisconsin, has applied to the town board for a license to sell at [retail or wholesale] beverages containing less than one-half of one percent of alcohol by volume to be consumed [on or off] the premises where sold on the following described premises within the town: [describe premises];
It is ordered as follows:
1. That the application for the license applied for be granted, upon payment of the following license fee: $________;
2. That the town clerk sign and deliver the license to each license applicant, upon producing to the clerk a receipt, showing the payment to the town treasurer of the license fee required under this order.
Dated this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
The following statutes affect this form: ss. 77.61 (11) and 134.65, Wis. stats. STATE OF WISCONSIN
Town of ________
________ County
________ ________, of the Town of ________, ________ County, Wisconsin, having done all of the following:
1. Filed with the undersigned town clerk a complete application for a tobacco products retailer license.
2. Paid the license fee of $_____ [amount may not be less than $5 nor more than $100] to the treasurer of the town.
3. Submitted the proof required under s. 77.61 (11), Wis. stats. And the application having been granted by the town board on __________, _____, 20__;
A tobacco products retailer license is granted to __________ __________ to sell cigarettes, electronic vaping devices, and tobacco products under s. 134.65, Wis. stats., on the following premises in the town: [describe premises].
