1. I am the owner of land abutting the Interstate right of way at the location shown below. As an abutting landowner, I have the right under South Dakota Codified Law (SDCL) and the Administrative Rules of South Dakota (ARSD) to mow and use hay in the following ditch(es):
Check one: E W N S or Both side(s) of Highway
From Mile Post to Mile Post ,
(or as identified by the following legal description:)

2. By this Waiver, made pursuant to ARSD 70:04:06:05, I waive my right to mow and use this hay and give this right to the following non-abutting person, who may then apply to the South Dakota Department of Transportation for the required permit:

Printed Name of Non-Abutting Person Address of Non-Abutting Person

Printed Name of Abutting Landowner Address of Abutting Landowner

___________________________________
Signature of Abutting Landowner Date