Iowa Admin. Code r. 781-19.6 - Content of petition
A petition for
1. The name, address, and telephone number of
the entity or person for whom a waiver is being requested and the case number
of any related contested case.
2. A
description and citation of the specific rule from which a waiver is
requested.
3. The specific waiver
requested, including the precise scope and duration.
4. All relevant facts that the petitioner
believes would justify a waiver under each of the four criteria described in
rule 19.4(17A). This statement shall include a signed statement from the
petitioner attesting to the accuracy of the facts provided in the petition and
a statement of reasons that the petitioner believes will justify a
waiver
5. A history of any prior
contacts between the agency and the petitioner relating to the regulated
activity, license, or authorization affected by the proposed waiver , including
a description of each affected license or authorization held by the requester,
any notices of violation, contested case hearings, or investigative reports
relating to the regulated activity or license within the last five
years.
6. All information known to
the requester regarding the agency's treatment of similar cases.
7. The name, address, and telephone number of
any public agency or political subdivision which also regulates the activity in
question or which might be affected by the granting of a waiver
8. The name, address, and telephone number of
any entity or person who would be adversely affected by the granting of a
petition.
9. The name, address, and
telephone number of any person with knowledge of the relevant facts relating to
the proposed waiver .
10. Signed
releases of information authorizing persons with knowledge regarding the
request to furnish the agency with information relevant to the waiver
Notes
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