1. For driveway work, instead submit the Town Driveway Construction Permit Application.
2. The applicant (“Applicant”) must fill this form completely. Any inapplicable box must be marked “N/A.”
3. Applicant shall submit required plans and specifications and proof of insurance.
4. Applicant shall submit proof of Contractor’s work qualifications (for example, a copy of pages 1-4 of the Contractor’s State Form 96) and permit bond.
5. Enclose application fee of $100.00 ($75.00 if no cuts/bores), payable to Town of Shipshewana.
6. By signing below, Applicant agrees to be bound by all the enclosed Terms and Conditions.
7. Contact the Town of Shipshewana Street Department for questions concerning this application.