1. The applicant (“Applicant”) must fill this form completely. Any inapplicable box must be marked “N/A.”
2. Applicant shall submit required plans and specifications and proof of insurance.
3. Enclose application fee of $75.00 ($50.00 for unpaved field entrance), payable to Town of Shipshewana.
4. By signing below, Applicant agrees to be bound by all the enclosed Terms and Conditions.
5. Contact the Town of Shipshewana Street Department for questions concerning this application.