To the County Board of ________ County, Wisconsin:
The Town Board of the Town of ________, ________ County, Wisconsin, petitions the County Board of ________ County, Wisconsin, as follows:
1.   On ________ ___, 20__, the town board approved a resolution to [construct a or repair the] [bridge or culvert] lying [wholly or partly] within the town.
2.   The [bridge or culvert] to be [constructed or repaired] [has a 36-inch or greater span, or is a structure with an equivalent capacity to carry water of a bridge or culvert that has a 36-inch or greater span].
3.   [add in case of emergency under s. 82.08 (4)] By reason of a flood on or about ________ ___, 20__, the bridge was [washed out or damaged, or state other cause of the emergency], and it is necessary to [reconstruct or repair] the [bridge or culvert] without delay, as a result of [list the facts respecting the immediate necessity for the construction or repairs].
Wherefore the Town Board of the Town of ________ petitions for an appropriation to be made by the county to aid the [construction or repair] of the [bridge or culvert], as provided by s. 82.08, Wis. stats.
Dated this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
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