NOTE: Keep entries in fields short. Text or numbers that aren't visible won't print.



(To Be Completed By Lessee)

(Please Use Complete 3-Line Address)
Nearest City or Town Property is Located

NOTE: Applicant should understand that any structure including grain spouts, platforms, eaves, gutters, downspouts or other appurtenances shall normally have a lateral clearance of 8.5 feet from the centerline of tracks and vertical clearance of 23 feet above the top of rail and in no event will statutory clearances be infringed upon except through special handling.

Complete and return to:
SD Dept. of Transportation_______________________________________________ ____________
Office of Air, Rail & TransitApplicant Signature Date
700 E. Broadway Ave.
Pierre, SD 57501
Telephone (605) 773-3046

** Include a map of the property with dimensions **