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/S- 7
<br /> Example form PETITION TO ALTER SCHOOL DISTRICT BOUNDARIES
<br /> provided bY DPI Detachment and Attachment of Small Territory-see section 117.12,Wisconsin Statutes
<br /> The petitioner must complete Section 1,take the form to the municipal clerk to complete Section 2,and then submit the petition to the
<br /> school district where the property is located. See http://www.dpi.state.wius/sms/rgsmallo.htnnl on the Internet for more information.
<br /> The petition must be submitted to the school district BEFORE FEBRUARY 1.
<br /> SECTION 1 TO BE+ OMPLETED BS THE PERSON SuBNII , G THIS TON {c s
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<br /> Petitioner Name(s)K k a it d (/aCy I /'rl1h;4'11
<br /> Address(street,dty,zip)g6g16p/t/(L{Valley 6/QCkcini,, k/T-63.5(,
<br /> Phone Number 8-'1g -I 'd 1 E-mall 4rLLSS6y //�DM`i �y� 1
<br /> Legal Descri on of Territory Proposed for Detachment INCLUDING PARCEL NUMBERS: �01-/ w/r( /o 53 7
<br /> `”]i1R.rne/ :.ohLi-owo7-153-- '5o/ -v ;
<br /> Lot 3 CSI't' 105 317 eraX Parai : o04/oghr?-- 15 gV4I—10
<br /> .
<br /> (If more space Is needed to describe the property,attach additional pages)
<br /> I/we,the undersigned,representing 50%of the owners or a majority orf Electors o intor residing on the above described territory,
<br /> file this petition to detach the pbove decribed t rritory FROM the ■tSCD/1S&n 101 qi,c School District
<br /> and to attach it TO the(h d 1. (t tnn-L:f OSS P lat.11 S School District.
<br /> it--; (Use page 2foradr onal4igmtures If there_.are mult_ipie petttioners)_ , - (For wed nd►s twhe,} y-
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<br /> SIGNATURE(S) , ° y 7Ba�or .its
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<br /> SE r-6-.-21. BE COMP TEI B E ,.PF CIP 0t, :11'4 .T C3
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<br /> The legal description of the territory proposed for detachment is sufficient to identify Its location and value. YES / NO
<br /> (If no,return the form to the petitioner.) �/
<br /> • School District where territory is located 1JJi5 cons',ne' 1_,'hf5 Value of Property I)05 1) 3I>O.en
<br /> Munidpal ty where territory is located Try, r, err-Be,,,,ei Year Value was Determined a cl I LI
<br /> County where territory is located '(Io.Ne. Assessment Ratio I.65$5
<br /> I,the undersigned,certify that the property description in Section 1 is sufficient to determine its location and value and that the
<br /> information entered above in Section 2 is correct. 1
<br /> SIGNATURE OF MUNICIPAL CLERK -J 3 o _, r z.Q_ I Date: j-t b. j- 1
<br /> Name of Clerk(please print) 113 i eM a x 4 i a
<br /> Mailing Address c3 Olt +ezhc J tzatL l 9, 171112 0[Y1an i G tAX 535L a A
<br /> Phone Number (opg_ 747_ y05a _) E-mail Address I -1-wh berry/4aimrus rte+
<br /> 0 -a - iogic_OMP TED B3 lTE a R OF ;SCHOOL DISTR C r IN HIOB 1')l- A
<br /> .,. ° ._..,�, :,ta K'. TERItITORY3$:IOG il-please prin ortypej. ;`Y. 4 -t A 1
<br /> District receiving petition Date received
<br /> Lviw,�5cn 1 ghis I 1-16_1 '-J 1
<br /> Number of pupils residing In the territory described in Section> ivho were enrolled in the district as of the most recent 3'"Friday .1 f]K9(LQd.-J )
<br /> in September or 2' Friday in January(see x.121.05(1)(a),Wisconsin statutes). _ F3icta:l iS i
<br /> Name of School District clerk(please print) Urn e Otcu /I- Phone &OS.7q5-018.19
<br /> SIGNATURE OF SCHOOL DISTRICT CLERK I e.k
<br /> After completing Section 3 the clerk of the detaching school district must send a certified copy(a document . i;1.,:• i or a n i
<br /> photocopy accompanied by a Certificate of True Copy)of this petition to the school board of the school districf �v tithe pro. is ,(/
<br /> proposed to be attached and also to: v
<br /> Secretary,School District Boundary Appeal Board FEB 1 3'2015 ., 1
<br /> Department of Public Instruction (■ c A L�
<br /> . PO Box 7841 WI DPI- `M_ t 1 ?
<br /> Madison,WI 53707-7841 ,_ ...____�._._..__-._ I
<br /> (For more information contact Janice Zmrazek,608266-2803,Janice.zmrazeki dpi.wi.eov. Both districts must act on this petition by March 1.)
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