TO THE DEPARTMENT OF NATURAL RESOURCES:
The undersigned hereby petition(s) for a review of the department's (proposed rule) (decision) entitled and dated, 2 . The specific issue(s) requested to be reviewed (is) (are): The specific interest(s) of the petitioner(s) (is) (are): . The reasons why a hearing is warranted are: . Date
Signature(s)
Verification ____________________
Wis. Admin. Code Department of Natural Resources NR 203.17