Date:		Township:	Twn Bear Creek Twn Caledonia Twn Dayton Twn Dupont Twn Farmington Twn Fremont Twn Harrison Twn Helvetia Twn Iola Twn Larrabee Twn Lebanon Twn Lind Twn Little Wolf Twn Matteson Twn Mukwa Twn Royalton Twn Scandinavia Twn St. Lawrence Twn Union Twn Waupaca Twn Weyauwega Twn Wyoming Vil Big Falls Vil Embarrass Vil Fremont Vil Iola Vil Ogdensburg Vil Scandinavia Cty Clintonville Cty Manawa Cty Marion Cty New London Cty Waupaca Cty Weyauwega
Submitted By:		Property Owner Logger Other
Section #:		Township #:
Range #:
Is this MFL Land?	Yes No		If Yes, enter he MFL Order#
Legal Description:
Land Owner:
Address:
City State Zip:
Phone Number:
E-Mail:	Email required if you want an e-mail verification. A hard copy will also be mailed.
Logger
Address:
City State Zip:
Phone Number:
Parcel #1:		Parcel #2:
Parcel #3:		Parcel #4:
Parcel #5:
Type of cutting:	Logs Pulp Christmas Trees Misc MFL Land
Area:	A1 A2 A5 A6 A3 A4 A7 A8 A9 A10 A13 A14 A11 A12 A15 A16

Using the grid at the right, check the numbers below corresponding to the approximate area you will be cutting in. Click the box again to uncheck it.

When submitting multiple notices, please clear notice.