Wis. Admin. Code NR § 2.05
Petitions shall conform with the applicable statute as to form, content, number of signatories and verifications. All petitions shall be served within the time specified by statute or administrative rule, or, where no time is specified, within 30 days of the date of the order or decision to be reviewed. The department may request additional information concerning any petition or request served under this section. The department may deny any petition or request where the information required or requested under this section is not provided. Forms of petitions in various proceedings shall follow the following formats:
To the Department of Natural Resources:
The undersigned hereby petitions for a review of the department order dated, 20_, whereby it was ordered.
The grounds for this petition are
The modification or change desired is
Date
Signature
Verification
To the Department of Natural Resources:
The undersigned hereby petitions for the promulgation of a rule relating to:
The grounds for this petition are
The petitioners' interest in the request is
The authority of the department to act is
Date
Signatures (5 needed unless petitioner is a municipality or an association which is representative of a farm, labor, business or professional group)
To the Department of Natural Resources:
The undersigned hereby petitions for the amendment of rule number which provides as follows:
The grounds for this petition are
The modification or change desired is
The petitioners' interest in the request is
Date
Signatures (5 needed unless petitioner is a municipality or an association which is representative of a farm, labor, business or professional group)
To the Department of Natural Resources:
In the matter of the applicability of the following statute or rule The statute or rule provides as follows:
The grounds for this petition are to determine the applicability of the above provision because of the following state of facts:
The reasons for the requested ruling are
The following are the names and addresses of all other persons other than the petitioner upon whom it is sought to make the ruling binding:
Date
Name Address Signature Verification
To the Department of Natural Resources:
(Name)
(Address)
is causing or will cause alleged or potential environmental pollution, caused by the activities described herein:
The facts supporting the contention that alleged or potential environmental pollution is or will take place are as follows:
The nature of the alleged or potential environmental pollution is:
The specific relief sought by the complainants is:
Name and address of a person within the state authorized to receive service of the answer and other papers on behalf of the complainants:
(Name)
(Address)
Signatures of 6 or more citizens Verifications
To the Department of Natural Resources:
The undersigned hereby requests that a hearing be held as a contested case under s. 227.42, Stats.
The agency action or inaction which is the basis for the request for a hearing is:
The substantial interest injured or threatened with injury by agency action or inaction is:
The basis for a finding that there is no evidence of legislative intent that the interest is not to be protected is:
The injury to the person requesting the hearing is different in kind or degree from injury to the general public caused by the agency action or inaction because:
There is a dispute of material fact, and the disputed facts are:
The statute or administrative rule other than s. 227.42, Stats., if any, which accords a right to a hearing is:
(Signature)
(Address)
Wis. Admin. Code Department of Natural Resources § NR 2.05